Provider Demographics
NPI: | 1174896369 |
---|---|
Name: | TREASURE COAST ANESTHESIA ASSOCIATES |
Entity type: | Organization |
Organization Name: | TREASURE COAST ANESTHESIA ASSOCIATES |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | GENERAL PARTNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JAMES |
Authorized Official - Middle Name: | T |
Authorized Official - Last Name: | BROWN |
Authorized Official - Suffix: | JR |
Authorized Official - Credentials: | ARNP |
Authorized Official - Phone: | 772-260-5852 |
Mailing Address - Street 1: | 1255 37TH ST |
Mailing Address - Street 2: | STE E |
Mailing Address - City: | VERO BEACH |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 32960-6550 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 772-226-9950 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1255 37TH ST |
Practice Address - Street 2: | STE E |
Practice Address - City: | VERO BEACH |
Practice Address - State: | FL |
Practice Address - Zip Code: | 32960-6550 |
Practice Address - Country: | US |
Practice Address - Phone: | 772-260-5852 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2012-02-17 |
Last Update Date: | 2012-02-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 367500000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | Group - Single Specialty |