Basic Information
| Provider Information | |||||||||
| NPI: | 1801202171 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SOUTHERN ANESTHESIA PROVIDERS, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1325 S CONGRESS AVE | ||||||||
| Address2: | SUITE 211 | ||||||||
| City: | BOYNTON BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334265876 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5617402900 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2351 S SEACREST BLVD | ||||||||
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| City: | BOYNTON BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334356759 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5617325900 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2014 | ||||||||
| LastUpdateDate: | 07/08/2014 | ||||||||
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| AuthorizedOfficialLastName: | MCGUIRE | ||||||||
| AuthorizedOfficialFirstName: | DANIEL | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5617385772 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.