Organization
BLUE ANGEL ANESTHESIA SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER COULAHAN (ADMINISTRATOR)
(850) 494-0048
Entity
Organization
Contact information
Practice address
4600 N DAVIS HWY, PENSACOLA, FL 32503-2337
(850) 494-0048
(850) 494-0065
Mailing address
4600 N DAVIS HWY, PENSACOLA, FL 32503-2337
(850) 494-0048
(850) 494-0065
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34515
BCBS
FL
Enumeration date
12/01/2006
Last updated
08/22/2020
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