Ana C Asis, MD

Individual provider Active NPI Anesthesiology Physician · Dacula, GA

NPI 1336109552 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1336109552
Entity type
Individual (NPI type 1)
Primary specialty
Anesthesiology Physician 207L00000X
License
ME72195 (FL)
Practice address
3343 Mill Grove Ter
Dacula, GA 30019-5013
Phone
(770) 614-5376
Fax
(770) 614-5376
NPI assigned
Mar 23, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME72195FLMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesco North Broward LLC Anesthesiology Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X ME72195 FL Yes

Addresses

Primary practice location

3343 Mill Grove Ter
Dacula, GA 30019-5013

Mailing address

3343 Mill Grove Ter
Dacula, GA 30019-5013
Phone (770) 614-5376

Other providers in Dacula, GA

All providers in Dacula, GA · Anesthesiology Physician in Georgia

Sources for this page

Verify at the official NPI Registry.