Provider Demographics
NPI:1831517440
Name:GULF COAST PROFESSIONAL ANESTHESIA ASSOCIATES LLC
Entity type:Organization
Organization Name:GULF COAST PROFESSIONAL ANESTHESIA ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXEC. DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:G
Authorized Official - Last Name:ADKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-424-0869
Mailing Address - Street 1:PO BOX 3048
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62708-3048
Mailing Address - Country:US
Mailing Address - Phone:240-469-2181
Mailing Address - Fax:240-342-3837
Practice Address - Street 1:1401 W BAY DR
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-2207
Practice Address - Country:US
Practice Address - Phone:888-851-4642
Practice Address - Fax:240-342-3837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-01
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty