Organization
LAKESHORE ANESTHESIA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLENNON A. BROWN M.D. (PRESIDENT)
(561) 723-9598
Entity
Organization
Contact information
Practice address
39200 HOOKER HIGHWAY, BELLE GLADE, FL 33430
(561) 996-6571
(561) 996-2898
Mailing address
PO BOX 24620 #CL 600017, WEST PALM BEACH, FL 33416-4620
(561) 723-9598
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME81129
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
259768300
—
FL
Enumeration date
08/07/2008
Last updated
01/08/2018
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