Provider Demographics
NPI:1053803007
Name:GLOBAL ANESTHESIA EXECUTIVE SERVICES LLC
Entity type:Organization
Organization Name:GLOBAL ANESTHESIA EXECUTIVE SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:VICTOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:888-221-5754
Mailing Address - Street 1:3296 N FEDERAL HWY UNIT 11205
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33306-1033
Mailing Address - Country:US
Mailing Address - Phone:973-698-7768
Mailing Address - Fax:888-371-1413
Practice Address - Street 1:3536 N FEDERAL HWY STE 102
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-6264
Practice Address - Country:US
Practice Address - Phone:888-221-5754
Practice Address - Fax:888-371-1413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-05
Last Update Date:2018-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME100973207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty