Provider Demographics
NPI:1104599513
Name:CAPITAL ANESTHESIA SOLUTIONS OF KY II LLC
Entity type:Organization
Organization Name:CAPITAL ANESTHESIA SOLUTIONS OF KY II LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR DIRECTOR OF PROVIDER ENROLLMENT
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-910-6182
Mailing Address - Street 1:13500 POWERS CT STE 230
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-4503
Mailing Address - Country:US
Mailing Address - Phone:239-790-5582
Mailing Address - Fax:239-790-5582
Practice Address - Street 1:2511 TERRA CROSSING BLVD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40245-5375
Practice Address - Country:US
Practice Address - Phone:239-790-5582
Practice Address - Fax:239-790-5582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-30
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty