Organization
ANESTHESIA COMPANY OF AMERICA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARL RICHARDSON NOBACK MD (PRESIDENT)
(941) 360-1566
Entity
Organization
Contact information
Practice address
1564 KINGSLEY AVE, ORANGE PARK, FL 32073-4511
(904) 264-0400
Mailing address
201 MONTGOMERY AVE, SARASOTA, FL 34243-1519
(941) 360-1566
(941) 358-9818
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
03/03/2008
Last updated
03/03/2008
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