Provider Demographics
NPI:1285875740
Name:BRADENTON ANESTHESIA SERVICES LLC
Entity type:Organization
Organization Name:BRADENTON ANESTHESIA SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PAYOR RELATIONS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTELLANA
Authorized Official - Suffix:
Authorized Official - Credentials:CPCS
Authorized Official - Phone:813-569-6500
Mailing Address - Street 1:5501 W GRAY ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-1007
Mailing Address - Country:US
Mailing Address - Phone:813-569-6500
Mailing Address - Fax:813-569-6262
Practice Address - Street 1:6002 POINTE WEST BLVD
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-5531
Practice Address - Country:US
Practice Address - Phone:813-569-6500
Practice Address - Fax:813-569-6262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-13
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty