NPIMap

Organization Active NPI

Palm Bay Anesthesia Associates PA

  • Anesthesiology Physician
  • Palm Bay, FL
National Provider Identifier
1851324800
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
PALM BAY ANESTHESIA ASSOCIATES PA
Practice address
1425 Malabar Rd NE
Palm Bay, FL 32907-2506
Phone
(321) 434-8025
NPI assigned
Jul 9, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mark Vandenbosch, MDNPI 1871686733
Title
Owner
Phone
(321) 784-3700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X FL Primary

Addresses

Primary practice location

1425 Malabar Rd NE
Palm Bay, FL 32907-2506

Mailing address

804 Scott Nixon Memorial Dr
Augusta, GA 30907-2464
Phone (706) 650-0705

National Provider Directory

National Provider Directory

Locations

1340 Medical Park Dr
Melbourne, FL 32901
Phone (321) 434-8000

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1851324800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SCOTT NIXON MEMORIAL DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309072464",
            "telephone_number": "706-650-0705",
            "fax_number": "706-650-1034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 MALABAR RD NE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329072506",
            "telephone_number": "321-434-8025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALM BAY ANESTHESIA ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "VANDENBOSCH",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-784-3700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.