Provider Demographics
NPI:1972232023
Name:OFFICE ANESTHESIA STAFFING
Entity type:Organization
Organization Name:OFFICE ANESTHESIA STAFFING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:TIPPIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-203-5114
Mailing Address - Street 1:901 34TH AVE N UNIT 7266
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33734-8011
Mailing Address - Country:US
Mailing Address - Phone:727-203-5114
Mailing Address - Fax:
Practice Address - Street 1:901 34TH AVE N UNIT 7266
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33734-8011
Practice Address - Country:US
Practice Address - Phone:727-203-5114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty