Organization
FLORIDA GULF-TO-BAY ANESTHESIOLOGY ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEVANAND MANGAR M.D. (PRESIDENT)
(813) 844-4396
Entity
Organization
Contact information
Practice address
300 CIRCLE FRONT DR, EVANSVILLE, IN 47715-7196
(813) 844-4396
(813) 844-4972
Mailing address
809 S ALBANY AVE, TAMPA, FL 33606-2407
(813) 844-4396
(813) 844-4972
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
FL
207L00000X
Anesthesiology Physician
Primary
—
IN
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
—
FL
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
FL
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200808150A
—
IN
05
—
262127400
—
FL
01
—
45642
BCBS GROUP NUMBER
FL
01
—
DD7966
RR MEDICARE
IN
Enumeration date
05/12/2006
Last updated
06/21/2018
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