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Organization

CENTRAL BREVARD ANESTHESIOLOGISTS, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANDREA ORPHANOS MD (PRESIDENT)
(321) 637-2616
Entity
Organization

Contact information

Practice address
110 LONGWOOD AVE, ATTN: 2ND FLOOR OPERATING ROOM, ROCKLEDGE, FL 32955
(321) 637-2616
(321) 637-2986
Mailing address
P.O. BOX 561420, ROCKLEDGE, FL 32956
(321) 637-2616
(321) 637-2986

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
207LP2900X
Pain Medicine (Anesthesiology) Physician
367500000X
Certified Registered Nurse Anesthetist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
24916
BCBS
FL
05
375517700
FL
Enumeration date
06/04/2006
Last updated
11/21/2011
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