Proactive Anesthesia Management LLC
Nurse Anesthetist, Certified Registered in Jacksonville Beach, FL. Organization (NPI-2).
NPI number1194060624
StatusActive
Last updated in NPPESJun 21, 2013
Details
- NPI
- 1194060624
- Entity type
- Organization (NPI-2)
- Legal business name
- Proactive Anesthesia Management LLC
- Organization subpart
- No
- Enumeration date
- Dec 10, 2012
- Last updated
- Jun 21, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | – | – | Yes |
| 207L00000X | Anesthesiology | – | – |
Practice location
320 1st St NSuite 603
Jacksonville Beach, FL 32250-6944
Phone 904-274-3310
Mailing address
320 1st St NSuite 603
Jacksonville Beach, FL 32250-6944
Phone 904-274-3310
Authorized official
Ian Davies
Ceo
9042743310
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