Provider Demographics
NPI:1396992806
Name:ANESTHESIA & DISASTER MEDICAL SERVICES INC
Entity type:Organization
Organization Name:ANESTHESIA & DISASTER MEDICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:A
Authorized Official - Last Name:WEGNER
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:863-471-1413
Mailing Address - Street 1:11103 SUN TREE RD
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-5541
Mailing Address - Country:US
Mailing Address - Phone:863-471-1413
Mailing Address - Fax:863-471-1416
Practice Address - Street 1:11103 SUN TREE RD
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-5541
Practice Address - Country:US
Practice Address - Phone:863-471-1413
Practice Address - Fax:863-471-1416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 1422382367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist AssistantGroup - Single Specialty