Provider Demographics
NPI:1528083243
Name:JS ANESTHESIA INC
Entity type:Organization
Organization Name:JS ANESTHESIA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:SPANN
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:239-691-5750
Mailing Address - Street 1:5731 HARBORAGE DR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-4551
Mailing Address - Country:US
Mailing Address - Phone:239-691-5750
Mailing Address - Fax:239-275-0503
Practice Address - Street 1:3700 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-7649
Practice Address - Country:US
Practice Address - Phone:239-275-0665
Practice Address - Fax:239-275-0503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1388142367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty