NPIMap

Organization Active NPI

Waterman Anesthesiology Group PA

  • Anesthesiology Physician
  • Tavares, FL
National Provider Identifier
1801130588
Registry record updated Nov 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
WATERMAN ANESTHESIOLOGY GROUP PA
Practice address
1000 Waterman Way
Tavares, FL 32778-5266
Phone
(352) 253-3765
Fax
(352) 253-3487
NPI assigned
Nov 19, 2012
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. Douglas A Olin, MD
Title
Director
Phone
(407) 667-0444

Practitioners 105

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 105

National Provider Directory

National Provider Directory

Locations

291 Southhall Ln
Ste 201
Maitland, FL 32751
Phone 40766704444

Specialties & licenses 4

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X
Pediatric Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP3000X
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X

Addresses

NPPES NPI Registry

Primary practice location

1000 Waterman Way
Tavares, FL 32778-5266

Mailing address

291 Southhall LN
Suite 201
Maitland, FL 32751-7274
Phone (407) 667-0444

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
PENDINGOtherFLBCBS
PENDINGMedicaidFL

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 19, 2012.

{
    "created_epoch": "1353283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353283200000",
    "number": "1801130588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 SOUTHHALL LN",
            "address_2": "SUITE 201",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517274",
            "telephone_number": "407-667-0444",
            "fax_number": "407-667-4338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 WATERMAN WAY",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327785266",
            "telephone_number": "352-253-3765",
            "fax_number": "352-253-3487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERMAN ANESTHESIOLOGY GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-19",
        "last_updated": "2012-11-19",
        "status": "A",
        "authorized_official_last_name": "OLIN",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "407-667-0444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "PENDING",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tavares, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.