Organization
BIBY ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN NICHOLAS IDA DO (OWNER)
(847) 989-0874
Entity
Organization
Contact information
Practice address
2438 DR MARTIN LUTHER KING JR ST N, ST PETERSBURG, FL 33704-2750
(727) 565-0740
Mailing address
422 CYPRESS VIEW DR, OLDSMAR, FL 34677-4631
(847) 989-0874
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
12/09/2021
Last updated
12/09/2021
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