Prestige Anesthesia LLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

ME111972 Issued in FL

Legal business name

PRESTIGE ANESTHESIA LLC

Practice address

6375 NW 120TH Dr
Coral Springs, FL 33076-1904

Phone

(954) 800-7350

Fax

(954) 800-7350

NPI assigned

Oct 15, 2014

Last updated

Oct 15, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Justin Barack, M.D.

Title

Managing Member

Phone

(954) 299-0900

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1413331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413331200000",
    "number": "1982008215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6375 NW 120TH DR",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330761904",
            "telephone_number": "954-800-7350",
            "fax_number": "954-800-7350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6375 NW 120TH DR",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330761904",
            "telephone_number": "954-800-7350",
            "fax_number": "954-800-7350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE ANESTHESIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-15",
        "last_updated": "2014-10-15",
        "status": "A",
        "authorized_official_last_name": "BARACK",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "954-299-0900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME111972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premier Primary Care Corporation
• Premise Health of Florida Medical PA (City of Coral Springs)
• Premium Vision Group (Premium Eye Care)
• Chad Allen Prescott, CRNA
• Irina Prescott, NP
• Prestige Manor of Coral Springs
• Prestige Psychiatry,Inc.
• Joanne Preston, P.T.
• Richard Anthony Presutti, MD
• Marissa Prezzemolo, APRN, FNP-BC

• Anesthesiology Physician in Coral Springs, FL
• Providers in Coral Springs, FL by specialty
• Anesthesiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2014; 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.