Basic Information
| Provider Information | |||||||||
| NPI: | 1811420805 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SAGE ANESTHESIA SERVICES PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 865541 | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328865541 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8883373509 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6500 66TH ST N | ||||||||
| Address2: | |||||||||
| City: | PINELLAS PARK | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337815030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7278281460 | ||||||||
| FaxNumber: | 7278281461 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2017 | ||||||||
| LastUpdateDate: | 04/19/2017 | ||||||||
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| AuthorizedOfficialLastName: | PARMAR | ||||||||
| AuthorizedOfficialFirstName: | RAVIINDER | ||||||||
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| AuthorizedOfficialTitleorPosition: | MEDICAL DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 2392939878 | ||||||||
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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 | 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 |
No ID Information.