Basic Information
| Provider Information | |||||||||
| NPI: | 1184661696 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ORLANDO ANESTHESIA CONSULTANTS PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1901 ULMERTON RD STE 485 | ||||||||
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| City: | CLEARWATER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337622312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7272108230 | ||||||||
| FaxNumber: | 8555088465 | ||||||||
| Practice Location | |||||||||
| Address1: | 10000 W COLONIAL DR | ||||||||
| Address2: | |||||||||
| City: | OCOEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347613498 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4076670444 | ||||||||
| FaxNumber: | 4076674338 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2006 | ||||||||
| LastUpdateDate: | 09/17/2018 | ||||||||
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| AuthorizedOfficialLastName: | SEFTON | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 4075927864 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LC0200X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology | Critical Care Medicine | 207LP2900X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine | 367500000X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 207L00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 99860 | 01 | FL | BCBS | OTHER | 251715900 | 05 | FL | MEDICAID |