Healthcare Provider Details

I. General information

NPI: 1144273525
Provider Name (Legal Business Name): PAMELA A. GILL CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 11/04/2021
Certification Date: 10/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GAP ANESTHESIA RESOURCES LLC 605 ISLEBAY DRIVE
APOLLO FL
33572-3336
US

IV. Provider business mailing address

GAP ANESTHESIA RESOURCES LLC 605 ISLEBAY DRIVE
APOLLO FL
33572-3336
US

V. Phone/Fax

Practice location:
  • Phone: 813-777-5559
  • Fax:
Mailing address:
  • Phone: 813-777-5559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR100940
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP9241575
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number9241575
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License NumberARNP9241575
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAC002829
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: