Provider Demographics
NPI:1386117331
Name:HIGHLANDS ANESTHESIA LLC
Entity type:Organization
Organization Name:HIGHLANDS ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:ROS CARRETERO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-287-5718
Mailing Address - Street 1:5483 W WATERS AVE STE 1200
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-1236
Mailing Address - Country:US
Mailing Address - Phone:913-287-5718
Mailing Address - Fax:813-287-5728
Practice Address - Street 1:2820 BRIARWOOD LN
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33875-4760
Practice Address - Country:US
Practice Address - Phone:813-287-5718
Practice Address - Fax:813-287-5728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-02
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty