South Lake Anesthesia Services, P.A.

LBN: South Lake Anesthesia Services, P.A.
South Lake Anesthesia Services, P.A. is an health care organization with primary practice located at 1900 Don Wickham Dr , Clermont FL 34711-1979. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is the primary health care specialty. South Lake Anesthesia Services, P.A. can be contacted via phone (352) 243-9114, or through Ghivizzani, David S via phone (352) 243-9114.

Contact Information

Primary practice address
1900 Don Wickham Dr Clermont FL 34711-1979
Phone: (352) 243-9114
Fax: (352) 243-7822
Website:
Map and Directions
Authorized official contact:
Name: Ghivizzani, David S Doctor of Medicine (MD)
Phone: (352) 243-9114

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X Florida
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X

Profile Details

NPI number 1346255056
LBN Legal business name South Lake Anesthesia Services, P.A.
DBA Doing business as
Authorized official Ghivizzani, David S Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 30th, 2006
Last updated Dec 9th, 2011 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346255056 NPPES
Florida MEDICAID 259314900
Florida Other DA3883
Florida Other 45233

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