Provider Demographics
NPI:1972913010
Name:APNEA ANESTHESIA
Entity type:Organization
Organization Name:APNEA ANESTHESIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DWAIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-843-0630
Mailing Address - Street 1:1496 WACKER AVE SE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32909-5261
Mailing Address - Country:US
Mailing Address - Phone:203-843-0630
Mailing Address - Fax:
Practice Address - Street 1:1496 WACKER AVE SE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32909-5261
Practice Address - Country:US
Practice Address - Phone:203-843-0630
Practice Address - Fax:321-773-7239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-29
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME98839207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty