Organization
FAIRCHILD ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP GROSSMAN MD (AUTHORIZED OFFICIAL)
(304) 270-7572
Entity
Organization
Contact information
Practice address
7875 SW 104TH ST, STE 201, MIAMI, FL 33156-2642
(305) 270-7572
Mailing address
201 MONTGOMERY AVE, SARASOTA, FL 34243-1519
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
05/03/2010
Last updated
10/07/2011
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