Healthcare Provider Details

I. General information

NPI: 1902035702
Provider Name (Legal Business Name): DAVID FRANCIS OBRIEN CRNA, ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2009
Last Update Date: 07/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15342 BRIAR RIDGE CIR 16051 BRIARCLIFF LANE
FORT MYERS FL
33912-2316
US

IV. Provider business mailing address

16051 BRIARCLIFF LN 15342 BRIAR RIDGE CIRCLE
FORT MYERS FL
33912-4225
US

V. Phone/Fax

Practice location:
  • Phone: 239-633-3253
  • Fax: 941-227-0967
Mailing address:
  • Phone: 239-633-3253
  • Fax: 941-229-0967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP1867212
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number3511411
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: