Registry details
Type
Individual
Primary specialty
Nurse Anesthetist, Certified Registered
Enumerated
Jul 10, 2006
License(s)
102699 (TX), APRN9447997 (FL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 38135 MARKET SQ | Zephyrhills, FL 33542-7539 | 352-567-0188 |
| LOCATION | 14547 BRUCE B DOWNS BLVD | Tampa, FL 33613 | 813-978-1494 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.