Organization
GULF-TO-BAY ANESTHESIOLOGY ASSOCIATES LLC
Active
Other names
GTBA Pain Van Dyke
Organization subpart
No
Provider details
NPI number
Authorized official
DEVANAND MANGAR MD (CEO/PRESIDENT)
(813) 844-4434
Entity
Organization
Contact information
Practice address
4961 VAN DYKE RD, LUTZ, FL 33558-4813
(813) 253-2273
(813) 253-2279
Mailing address
809 S ALBANY AVE, TAMPA, FL 33606-2407
(813) 844-4396
(813) 844-4972
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
208VP0000X
Pain Medicine Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Enumeration date
11/09/2009
Last updated
04/27/2012
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