1649463365 NPI number — SWEET DREAMS NURSE ANESTHESIA, INC.

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 1649463365 NPI number — SWEET DREAMS NURSE ANESTHESIA, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SWEET DREAMS NURSE ANESTHESIA, INC.
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:
1649463365
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/14/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 850001 DEPT 740T
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:
32885-4380
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
941-360-1566
Provider Business Mailing Address Fax Number:
941-358-9818

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4080 MCGINNIS FERRY RD STE 102
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALPHARETTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30005-3901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-728-0882
Provider Business Practice Location Address Fax Number:
888-512-1507
Provider Enumeration Date:
08/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DERANEY
Authorized Official First Name:
JARED
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
480-482-0934

Provider Taxonomy Codes

  • Taxonomy code: 367500000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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