Provider Demographics
NPI:1316751647
Name:MD CARDIAC ANESTHESIA AND CRITICAL CARE PLLC
Entity type:Organization
Organization Name:MD CARDIAC ANESTHESIA AND CRITICAL CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR CARDIAC ANESTHESIA
Authorized Official - Prefix:DR
Authorized Official - First Name:DILLON
Authorized Official - Middle Name:
Authorized Official - Last Name:TINEVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-987-2903
Mailing Address - Street 1:3001 CASTELLI BLVD
Mailing Address - Street 2:
Mailing Address - City:MOUNT DORA
Mailing Address - State:FL
Mailing Address - Zip Code:32757-6519
Mailing Address - Country:US
Mailing Address - Phone:773-987-2903
Mailing Address - Fax:
Practice Address - Street 1:3001 CASTELLI BLVD
Practice Address - Street 2:
Practice Address - City:MOUNT DORA
Practice Address - State:FL
Practice Address - Zip Code:32757-6519
Practice Address - Country:US
Practice Address - Phone:773-987-2903
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty