Provider Demographics
NPI:1023067600
Name:SUNRISE ANESTHESIOLOGY OF MICHIGAN, PC
Entity type:Organization
Organization Name:SUNRISE ANESTHESIOLOGY OF MICHIGAN, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HORACIO
Authorized Official - Middle Name:G
Authorized Official - Last Name:LARDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-573-5267
Mailing Address - Street 1:7 W SQUARE LAKE RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-0462
Mailing Address - Country:US
Mailing Address - Phone:586-573-5267
Mailing Address - Fax:
Practice Address - Street 1:2700 S ROCHESTER RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-4547
Practice Address - Country:US
Practice Address - Phone:248-844-3800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty