Provider Demographics
NPI:1164657995
Name:ANESTHESIA PROFESSIONAL SERVICES OF BREVARD LLC
Entity type:Organization
Organization Name:ANESTHESIA PROFESSIONAL SERVICES OF BREVARD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:TOBKES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:888-447-7220
Mailing Address - Street 1:PO BOX 16068
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27261-6068
Mailing Address - Country:US
Mailing Address - Phone:336-821-4183
Mailing Address - Fax:336-884-1643
Practice Address - Street 1:1974 US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-3756
Practice Address - Country:US
Practice Address - Phone:888-447-7220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-22
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty