Organization
PANHANDLE ANESTHESIOLOGY ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANUEL F. SIVERIO JR. (ADMINISTRATOR)
(850) 477-7042
Entity
Organization
Contact information
Practice address
4901 GRANDE DR, PENSACOLA, FL 32504-5935
(850) 477-7042
(850) 474-9060
Mailing address
4901 GRANDE DR, PENSACOLA, FL 32504-5935
(850) 477-7042
(850) 474-9060
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
057404000
—
FL
01
—
529000180
ALABAMA MEDICAID
AL
01
—
99096
BLUE CROSS BLUE SHIELD
FL
01
—
CB2233
RAIL ROAD MEDICARE
—
Enumeration date
08/09/2005
Last updated
12/15/2015
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