Provider Demographics
NPI:1902316557
Name:ANESTHESIA AFICIANADOS, LLC
Entity Type:Organization
Organization Name:ANESTHESIA AFICIANADOS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:H
Authorized Official - Last Name:SALZARULO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:864-482-5100
Mailing Address - Street 1:PO BOX 2585
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31902-2585
Mailing Address - Country:US
Mailing Address - Phone:706-660-8505
Mailing Address - Fax:706-660-1454
Practice Address - Street 1:10630 CLEMSON BLVD STE 200
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29678-4545
Practice Address - Country:US
Practice Address - Phone:864-482-5100
Practice Address - Fax:864-482-9100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-10
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13790207L00000X
207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty