Provider Demographics
NPI:1730161993
Name:SEBASTIAN RIVER ANESTHESIOLOGY ASSOCIATES, P. A.
Entity type:Organization
Organization Name:SEBASTIAN RIVER ANESTHESIOLOGY ASSOCIATES, P. A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:POLLIZZI
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:941-575-8227
Mailing Address - Street 1:PO BOX 510460
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33951-0460
Mailing Address - Country:US
Mailing Address - Phone:941-575-8227
Mailing Address - Fax:941-575-1879
Practice Address - Street 1:13695 US HIGHWAY 1
Practice Address - Street 2:SEBASTIAN RIVER MEDICAL CENTER
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-3230
Practice Address - Country:US
Practice Address - Phone:772-581-2080
Practice Address - Fax:772-581-2081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL34240OtherFL BLUE SHIELD PROV NUMBE
FLK3367Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER