Provider Demographics
NPI:1861874091
Name:NOVA ANESTHESIA PROVIDERS LLC
Entity type:Organization
Organization Name:NOVA ANESTHESIA PROVIDERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:F
Authorized Official - Last Name:ANSHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-360-1566
Mailing Address - Street 1:6094 14TH ST W
Mailing Address - Street 2:STE 133
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34207-4104
Mailing Address - Country:US
Mailing Address - Phone:941-360-1566
Mailing Address - Fax:941-358-9818
Practice Address - Street 1:4660 KENMORE AVE
Practice Address - Street 2:STE 100
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-1313
Practice Address - Country:US
Practice Address - Phone:703-751-5763
Practice Address - Fax:703-370-4655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-24
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty