Provider Demographics
NPI:1881712016
Name:ALLMED ANESTHESIA ASSOCIATES, LLC
Entity type:Organization
Organization Name:ALLMED ANESTHESIA ASSOCIATES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WITFORD
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:REID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:863-471-1413
Mailing Address - Street 1:PO BOX 528
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33871-0528
Mailing Address - Country:US
Mailing Address - Phone:863-471-1413
Mailing Address - Fax:863-471-1416
Practice Address - Street 1:9 RYANT BLVD
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33872-4075
Practice Address - Country:US
Practice Address - Phone:863-471-1413
Practice Address - Fax:863-471-1416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME76048174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL258014400Medicaid
FL050070732OtherRAILROAD MEDICARE
FL46267OtherBCBS
FL46267OtherBCBS
FLK1304Medicare ID - Type Unspecified