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Coastal Anesthesia Providers, Llc

Anesthesiology

Allopathic & Osteopathic Physicians

6015 Pointe West Blvd, Bradenton, FL 34209-5525

PECOS Enrollment

Based on the most recent information from CMS, provider Coastal Anesthesia Providers, Llc does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1881005783
Provider Type
Organization
Full Name
Coastal Anesthesia Providers, Llc

Subpart
No
Enumeration Date
5/13/2014
Last Updated
5/13/2014

Contact Information

Practice Location

6015 Pointe West Blvd, Bradenton, FL 34209-5525

(941) 782-0101

Unlisted Fax

Mailing Location

PO Box 865054, Orlando, FL 32886-0001

(888) 337-3509

Unlisted Fax

Authorized Official

Nobck, Carl R (Medical Director)

(888) 337-3509

Provider Taxonomies

Code	Description	License
Code 207L00000X Primary	Description Anesthesiology Allopathic & Osteopathic Physicians	License Unlisted Issuer
Code 367500000X	Description Nurse Anesthetist, Certified Registered Physician Assistants & Advanced Practice Nursing Providers	License Unlisted Issuer

Coastal Anesthesia Providers, Llc

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Authorized Official

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Bradenton Anesthesia Services Llc

Smith, Daniel P

West Florida Anesthesia Consultants, Pa

Koselak, Dennis Eric

Hubert, James Anthony

Defreitas, Edward

Tran, Anthony

Premier Anesthesia Of Florida Llc

Ravvin, Mikhail Semyonovich

Florida Digestive Anesthesia Associates Llc