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Organization

WEST FLORIDA ANESTHESIA CONSULTANTS, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. EDWARD A. DEFREITAS M.D. (PRESIDENT)
(941) 798-3524
Entity
Organization

Contact information

Practice address
2010 59TH ST W, STE 4650, BRADENTON, FL 34209-4608
(941) 798-3524
Mailing address
PO BOX 30289, TAMPA, FL 33630-3289

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
367500000X
Certified Registered Nurse Anesthetist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
063724600
FL
Enumeration date
05/04/2006
Last updated
11/20/2012
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