Provider Demographics
NPI:1427432053
Name:ELITE ANESTHESIA OF FLORIDA LLC
Entity type:Organization
Organization Name:ELITE ANESTHESIA OF FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILSON
Authorized Official - Middle Name:
Authorized Official - Last Name:NUESA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-955-2284
Mailing Address - Street 1:695 ROUTE 46 W
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07004-1592
Mailing Address - Country:US
Mailing Address - Phone:201-955-2284
Mailing Address - Fax:201-955-2267
Practice Address - Street 1:342 CASTAWAY CAY DRIVE
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-2209
Practice Address - Country:US
Practice Address - Phone:201-955-2284
Practice Address - Fax:201-955-2267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty