1679859144 NPI number — SUNCOAST ANESTHESIA PARTNERS, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679859144 NPI number — SUNCOAST ANESTHESIA PARTNERS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SUNCOAST ANESTHESIA PARTNERS, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679859144
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/14/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 919368
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORLANDO
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32891-9368
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-337-3509
Provider Business Mailing Address Fax Number:
941-328-3997

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2089 HAWTHORNE ST
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
SARASOTA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34239-2308
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
941-952-1145
Provider Business Practice Location Address Fax Number:
941-952-1175
Provider Enumeration Date:
10/28/2011

Additional Information

Authorized Official

Authorized Official Last Name:
KUPERMAN
Authorized Official First Name:
DOUGLAS
Authorized Official Middle Name:
ALAN
Authorized Official Title or Position:
MEDICAL DIRECTOR
Authorized Official Telephone Number:
941-952-1145

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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