Healthcare Provider Details

I. General information

NPI: 1760775951
Provider Name (Legal Business Name): BETHANY A. GOSS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2011
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 CURLEW RD STE 5
DUNEDIN FL
34698-9307
US

IV. Provider business mailing address

1557 RIVER DEE LN
DUNEDIN FL
34698-4536
US

V. Phone/Fax

Practice location:
  • Phone: 727-771-8333
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11001107
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: