Provider Demographics
NPI:1548331192
Name:TBEC ANESTHESIA SERVICES LLC
Entity type:Organization
Organization Name:TBEC ANESTHESIA SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HEIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-872-9310
Mailing Address - Street 1:4809 N ARMENIA AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603-1447
Mailing Address - Country:US
Mailing Address - Phone:813-872-9310
Mailing Address - Fax:813-872-9311
Practice Address - Street 1:4809 N ARMENIA AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-1447
Practice Address - Country:US
Practice Address - Phone:813-872-9310
Practice Address - Fax:813-872-9311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL05000023720207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00232021OtherRAILROAD MEDICARE
FL94971Medicare PIN