Rivercoast Anesthesia, P.a.

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

License

11323 Issued in FL

Legal business name

RIVERCOAST ANESTHESIA, P.A.

Practice address

1899 Murrell Rd Ste 130
Rockledge, FL 32955-3285

Phone

(321) 305-5987

Fax

(321) 338-2977

NPI assigned

Aug 6, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Michael Delano Willis, M.D.

Title

President

Phone

(321) 305-5987

Specialties & licenses 1

Addresses

Other names 1

• Rivercoast Pain Management Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1438819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438819200000",
    "number": "1609252188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1899 MURRELL RD STE 130",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329553285",
            "telephone_number": "321-305-5987",
            "fax_number": "321-338-2977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1899 MURRELL RD STE 130",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329553285",
            "telephone_number": "321-305-5987",
            "fax_number": "321-338-2977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERCOAST ANESTHESIA, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-06",
        "last_updated": "2015-08-06",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DELANO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-305-5987",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "FL",
            "license": "11323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rivercoast Pain Management",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ann Marie Riordan, A.C.S.W., L.C.S.W.
• Mary Carol Riordan, RN
• River'S Edge Assisted Living LLC
• Dianelis Rivera Alonso, RBT
• Antonio Rivera, MD
• Syed Ashter Rizvi, MBBS, MD
• Nessa Mattea Roach, MASSAGE THERAPSIT
• Robert E. Barden MD PA
• Brandy Roberts
• Cynthia Roberts, PT

• Pain Clinic/Center in Rockledge, FL
• Providers in Rockledge, FL by specialty
• Pain Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.