Organization
LAKEWOOD AMBULATORY ANESTHESIA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARRY L. SEVERS MD (MEMBER MANAGER)
(941) 745-6829
Entity
Organization
Contact information
Practice address
6015 POINTE WEST BLVD, STE 101, BRADENTON, FL 34209-5525
(941) 360-1566
(941) 358-9818
Mailing address
PO BOX 25095, TAMPA, FL 33622-5095
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
FL
367500000X
Certified Registered Nurse Anesthetist
—
FL
Other
Enumeration date
11/06/2014
Last updated
11/06/2014
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