Provider Demographics
NPI:1952756728
Name:FPRA ANESTHESIA SERVICES LLC
Entity Type:Organization
Organization Name:FPRA ANESTHESIA SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CHERIAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:SAJAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-360-1566
Mailing Address - Street 1:6094 14TH ST W
Mailing Address - Street 2:#177
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34207-4104
Mailing Address - Country:US
Mailing Address - Phone:941-360-1566
Mailing Address - Fax:
Practice Address - Street 1:1693 LEE RD
Practice Address - Street 2:SUITE A
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-2260
Practice Address - Country:US
Practice Address - Phone:407-287-4300
Practice Address - Fax:407-982-8048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-29
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty