Healthcare Provider Details

I. General information

NPI: 1346269255
Provider Name (Legal Business Name): HOWARD VALENTINE CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 12/18/2020
Certification Date: 12/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 N CLYDE MORRIS BLVD SUITE 350
DAYTONA BEACH FL
32114-2781
US

IV. Provider business mailing address

1329 SW 16TH ST RM 2232
GAINESVILLE FL
32608-1128
US

V. Phone/Fax

Practice location:
  • Phone: 386-255-1266
  • Fax: 386-255-8520
Mailing address:
  • Phone: 352-733-0485
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP115207
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN1152072
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: