Healthcare Provider Details

I. General information

NPI: 1578554861
Provider Name (Legal Business Name): JAMES V MEYER CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2005
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 MANATEE AVE W
BRADENTON FL
34205-8610
US

IV. Provider business mailing address

1501 MANOR WAY S
ST PETERSBURG FL
33705-6122
US

V. Phone/Fax

Practice location:
  • Phone: 941-745-2727
  • Fax: 941-745-2112
Mailing address:
  • Phone: 727-866-8836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP1016952
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: