Organization
NORTHWEST ANESTHESIOLOGIST GROUP PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWIN RISI MD (MD/PRESIDENT)
(352) 867-8898
Entity
Organization
Contact information
Practice address
1100 NW 95TH STREET, MIAMI, FL 33150
(352) 867-8898
(352) 732-6282
Mailing address
PO BOX 550957, TAMPA, FL 33655-0957
(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
01
—
77291
BLUE CROSS BLUE SHIELD
—
Enumeration date
07/19/2007
Last updated
07/19/2007
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