Organization
MORTON PLANT MEASE OUTPATIENT ANESTHESIOLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL GUBBINI MD (PROVIDER RELATIONS)
(317) 614-9863
Entity
Organization
Contact information
Practice address
6600 MADISON ST, BOX 803, NEW PORT RICHEY, FL 34652-1971
(772) 842-8468
(844) 876-0873
Mailing address
PO BOX 198668, ATLANTA, GA 30384-8668
(855) 496-3580
(855) 371-8492
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
—
21538
BLUE CROSS BLUE SHIELD
FL
05
—
257274500
—
FL
01
—
CI6760
RAILROAD MEDICARE
FL
01
—
K0003
GROUP MEDICARE PTAN NUMBER
FL
Enumeration date
05/19/2006
Last updated
02/02/2017
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