# COMMONWEALTH ANESTHESIA GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275838625
- **Authorized official:** LANCE LASNER MD (MEMBER)
- **Authorized official phone:** (941) 360-1566

## Contact information

- **Practice address:** 3914 CENTREVILLE RD, STE 350, CHANTILLY, VA 20151-3289
- **Practice address phone:** (941) 360-1566
- **Practice address fax:** (941) 358-9818
- **Mailing address:** 6094 14TH ST W, STE 168, BRADENTON, FL 34207-4104
- **Mailing address phone:** (941) 360-1566
- **Mailing address fax:** (941) 358-9818

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |
| 367500000X | Certified Registered Nurse Anesthetist | — | NULL | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | — | — |

## Other

- **Enumeration date:** 01/17/2011
- **Last updated:** 03/06/2014