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NPI Code Detail

MEDICARE: GARY BROWN CRNA

MEDICARE: GARY BROWN CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse AnesthetistARNP9227820FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P00216189OTHERFLRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2G3746OTHERFLBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1730195835
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARY BROWN CRNA
Provider Business Mailing Address
First Line : PO BOX 106002
Second Line :
City : ATLANTA
State : GA
Zip : 30348-6002
Country : US
Telephone Number : 352-867-8898
Fax Number : 352-732-6282
Provider Business Practice Location Address
First Line : 2400 DUNDEE RD
Second Line :
City : WINTER HAVEN
State : FL
Zip : 33884-1166
Country : US
Telephone Number : 866-389-4848
Fax Number : 352-732-6282
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2006
Last Update Date : 07/12/2010

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Directions to “ GARY BROWN CRNA” Practice Location

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