Organization
LAKE COUNTY ANESTHESIA ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD GIOVANELLI MD (MD/PRESIDENT)
(352) 867-8898
Entity
Organization
Contact information
Practice address
600 E DIXIE AVE, LEESBURG, FL 34748-5925
(352) 867-8898
(352) 732-6282
Mailing address
PO BOX 917756, ORLANDO, FL 32891-7756
(352) 867-8898
(352) 732-6282
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
FL
367500000X
Certified Registered Nurse Anesthetist
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
262453200
—
FL
01
—
45985
BLUE CROSS BLUE SHIELD
FL
01
—
505428580
TRICARE
FL
01
—
CJ5985
RAILROAD MEDICARE
FL
Enumeration date
05/20/2006
Last updated
06/02/2009
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