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Organization
SONGBIRD ANESTHESIA INC
Active
Organization
SONGBIRD ANESTHESIA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUDOLPH PAVLESICH CRNA (PRESIDENT)
(904) 535-1875
Entity
Organization
Contact information
Practice address
1600 N SUMMER RIDGE CT, ST AUGUSTINE, FL 32092-3767
(904) 535-1875
Mailing address
1600 N SUMMER RIDGE CT, ST AUGUSTINE, FL 32092-3767
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
9178468
FL
Other
Enumeration date
08/23/2017
Last updated
08/23/2017
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