Organization
EAST COAST ANESTHESIA ASSOCIATES PA
Active
Organization
EAST COAST ANESTHESIA ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH INGRAM MD (OWNER)
(863) 357-6220
Entity
Organization
Contact information
Practice address
6830 S US HIGHWAY 1, PORT ST LUCIE, FL 34952-1410
(772) 934-6443
Mailing address
PO BOX 1106, STUART, FL 34995-1106
(863) 357-6220
(863) 357-6230
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN3309
MEDICARE RAILROAD
—
Enumeration date
04/07/2008
Last updated
03/01/2013
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