Organization
ANESTHESIA OUTPATIENT SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH W BACKSTRAND MD (PRESIDENT)
(239) 418-1004
Entity
Organization
Contact information
Practice address
805 DEL PRADO BLVD S, CAPE CORAL, FL 33990-2666
(239) 242-8010
Mailing address
PO BOX 60719, FORT MYERS, FL 33906-6719
(239) 418-1004
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME0050622
FL
Other
Enumeration date
08/21/2009
Last updated
01/20/2010
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