Healthcare Provider Details

I. General information

NPI: 1891942058
Provider Name (Legal Business Name): BRIDGIT LAMAY OWENS CRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2008
Last Update Date: 08/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 SW ARCHER ROAD (05B4)
GAINESVILLE FL
32608
US

IV. Provider business mailing address

21716 NW 78TH AVE
ALACHUA FL
32615-7023
US

V. Phone/Fax

Practice location:
  • Phone: 352-377-8977
  • Fax:
Mailing address:
  • Phone: 352-494-0991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License NumberTT 13829
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: