Provider Demographics
NPI:1457704389
Name:LEHIGH ANESTHESIOLOGY LLC
Entity Type:Organization
Organization Name:LEHIGH ANESTHESIOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:
Authorized Official - Last Name:CONOL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-898-2187
Mailing Address - Street 1:13022 MILFORD PL
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33913-8454
Mailing Address - Country:US
Mailing Address - Phone:239-898-2187
Mailing Address - Fax:
Practice Address - Street 1:13022 MILFORD PL
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33913-8454
Practice Address - Country:US
Practice Address - Phone:239-898-2187
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-15
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME87158207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty