Provider Demographics
NPI:1447666367
Name:GULF ADVANTAGE ANESTHESIA LLC
Entity type:Organization
Organization Name:GULF ADVANTAGE ANESTHESIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DIGBY
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:800-437-5179
Mailing Address - Street 1:6241 ARC WAY
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33966-1352
Mailing Address - Country:US
Mailing Address - Phone:800-437-5179
Mailing Address - Fax:239-278-9966
Practice Address - Street 1:6241 ARC WAY
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33966-1352
Practice Address - Country:US
Practice Address - Phone:800-437-5179
Practice Address - Fax:239-278-9966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-11
Last Update Date:2014-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty