Organization
CITRUS ANESTHESIA PROVIDERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEAN T PAULEY CRNA (OWNER)
(352) 634-2012
Entity
Organization
Contact information
Practice address
3075 W GULF TO LAKE HWY, LECANTO, FL 34461-9228
(352) 326-4014
(352) 326-4126
Mailing address
PO BOX 1300, LECANTO, FL 34460-1300
(352) 634-2012
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G9063
BLUE SHIELD PROVIDER NUMBER
FL
Enumeration date
03/31/2008
Last updated
09/17/2018
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