Provider Demographics
NPI:1962804724
Name:AVION ANESTHESIA, PLLC
Entity type:Organization
Organization Name:AVION ANESTHESIA, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-443-2108
Mailing Address - Street 1:4211 W BOY SCOUT BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-5724
Mailing Address - Country:US
Mailing Address - Phone:813-280-7810
Mailing Address - Fax:813-443-8255
Practice Address - Street 1:5301 AVION PARK DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-1416
Practice Address - Country:US
Practice Address - Phone:813-280-7810
Practice Address - Fax:813-443-8255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-23
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty