Basic Information
| Provider Information | |||||||||
| NPI: | 1134740319 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VISION ANESTHESIA LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 4485 | ||||||||
| Address2: | DEPT 1200 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 772104485 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9413601566 | ||||||||
| FaxNumber: | 9413589818 | ||||||||
| Practice Location | |||||||||
| Address1: | 9726 TOUCHTON RD STE 305 | ||||||||
| Address2: | |||||||||
| City: | JACKSONVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 322468307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9046866020 | ||||||||
| FaxNumber: | 9046198879 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/29/2020 | ||||||||
| LastUpdateDate: | 07/22/2021 | ||||||||
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| AuthorizedOfficialLastName: | KITCHENS | ||||||||
| AuthorizedOfficialFirstName: | KIRBY | ||||||||
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| AuthorizedOfficialTitleorPosition: | MEMBER/MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9413601566 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | CRNA | ||||||||
| NPICertificationDate: | 07/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 207L00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.