Organization
MARDI GRAS ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TROY ANTHONY MELANCON C.R.N.A. (PRESIDENT)
(239) 287-4376
Entity
Organization
Contact information
Practice address
13195 METRO PKWY UNIT 12-16, FORT MYERS, FL 33966-4810
(239) 236-2215
(239) 236-2219
Mailing address
9746 WILSHIRE LAKES BLVD, NAPLES, FL 34109-0752
(239) 287-4376
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
9189562
FL
Other
Enumeration date
01/27/2010
Last updated
08/27/2024
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