Healthcare Provider Details

I. General information

NPI: 1811633225
Provider Name (Legal Business Name): RICE FOREST GIFFIN DNAP, CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2022
Last Update Date: 07/06/2022
Certification Date: 07/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9655 BOYNTON BEACH BLVD
BOYNTON BEACH FL
33472-4421
US

IV. Provider business mailing address

3405 N ORANGE BLOSSOM TRL LOT 26
ORLANDO FL
32804-3408
US

V. Phone/Fax

Practice location:
  • Phone: 561-336-7000
  • Fax:
Mailing address:
  • Phone: 407-312-8353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11019835
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: