Active NPI
Southeast Anesthesia Associates
- Certified Registered Nurse Anesthetist
- Port St Lucie, FL
National Provider Identifier
1710026281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- Legal business name
- SOUTHEAST ANESTHESIA ASSOCIATES
- Practice address
- 1715 SE Tiffany Ave
Port St Lucie, FL 34952-7520 - Phone
- (772) 335-7005
- Fax
- (772) 335-3394
- NPI assigned
- Feb 5, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Robert A Dudley, CRNA
- Title
- Nurse Anesthesia
- Phone
- (772) 201-7510
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | Primary |
Addresses
Primary practice location
1715 SE Tiffany Ave
Port St Lucie, FL 34952-7520
Mailing address
PO Box 8178
Port St Lucie, FL 34985-8178
Phone (772) 335-7005
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 303534400 | Medicaid | FL |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Certified Registered Nurse Anesthetist
- Port Saint Lucie, FL
- NPI 1588799241
Nurse Anesthetist, Certified Registered
-
- Anesthesiologist Assistant
- Boynton Beach, FL
- NPI 1497779839
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170633600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1541116800000",
"number": "1710026281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8178",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349858178",
"telephone_number": "772-335-7005",
"fax_number": "772-335-3394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1715 SE TIFFANY AVE",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349527520",
"telephone_number": "772-335-7005",
"fax_number": "772-335-3394"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTHEAST ANESTHESIA ASSOCIATES",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-05",
"last_updated": "2018-11-02",
"status": "A",
"authorized_official_last_name": "DUDLEY",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "NURSE ANESTHESIA",
"authorized_official_telephone_number": "772-201-7510",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "CRNA"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Anesthetist, Certified Registered",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "303534400",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Port St Lucie, FL
- South Florida Counseling and Case Management, LLC
- South Florida Foot & Ankle Center
- South Florida Neuropathy Center Inc
- South Florida Orthopaedics & Sports Medicine, PA
- South Florida Vision Services, Inc.
- Southern Florida Psychiatric Services
- Southern Florida Psychiatric Services LLC
- Southern Home Care Services, Inc.
- Sovereign Healthcare of Port St. Lucie, LLC
- Rebecca Spayde
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.