Provider Demographics
NPI:1205130713
Name:DGASMD ANESTHESIA CONSULTANTS LLC
Entity type:Organization
Organization Name:DGASMD ANESTHESIA CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALBERTO
Authorized Official - Middle Name:PEREZ
Authorized Official - Last Name:DIMAGGIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-254-8072
Mailing Address - Street 1:854 ISLAND CLUB SQ
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32963-5505
Mailing Address - Country:US
Mailing Address - Phone:561-254-8072
Mailing Address - Fax:727-734-4516
Practice Address - Street 1:854 ISLAND CLUB SQ
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32963-5505
Practice Address - Country:US
Practice Address - Phone:561-254-8072
Practice Address - Fax:727-734-4516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-28
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME903.66174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty