NPIMap

Organization Active NPI

Florida Gulf Coast Anesthesia, LLC

  • Anesthesiology Physician
  • Pensacola, FL
National Provider Identifier
1013522325
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
FLORIDA GULF COAST ANESTHESIA, LLC
Practice address
4724 N Davis Hwy
Pensacola, FL 32503-2339
Phone
(850) 696-4000
NPI assigned
Sep 14, 2020
Last updated
Nov 4, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kim Tran, MD
Title
Manager
Phone
(818) 970-8191

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

4724 N Davis Hwy
Pensacola, FL 32503-2339

Mailing address

3104 Blue Lake Dr Ste 110
Vestavia, AL 35243-2372
Phone (205) 977-1949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201027001114 FL Part B Supplier - Clinic/Group Practice 8224458518 Receives reassigned benefits from 14 practitioners
Practice locations: Pensacola, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604448000000",
    "number": "1013522325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3104 BLUE LAKE DR STE 110",
            "city": "VESTAVIA",
            "state": "AL",
            "postal_code": "352432372",
            "telephone_number": "205-977-1949",
            "fax_number": "334-377-4417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4724 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032339",
            "telephone_number": "850-696-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA GULF COAST ANESTHESIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-14",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A",
        "authorized_official_last_name": "TRAN",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "818-970-8191",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.