Organization
NORTHWOOD ANESTHESIA ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN MARIE VAUGHN (OFFICER)
(404) 450-4684
Entity
Organization
Contact information
Practice address
7171 N DALE MABRY HWY, TAMPA, FL 33614-2630
(954) 939-5000
Mailing address
PO BOX 744429, ATLANTA, GA 30374-4429
(954) 939-5000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
FL
367500000X
Certified Registered Nurse Anesthetist
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
262610100
—
FL
01
—
38380
BLUE CROSS BLUE SHIELD
FL
01
—
CJ4022
RAILROAD MEDICARE
FL
Enumeration date
05/16/2006
Last updated
10/29/2024
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