Healthcare Provider Details

I. General information

NPI: 1134166523
Provider Name (Legal Business Name): LAVILIA TOUSSAINT CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAVILIA MOREAU CRNA

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

PO BOX 918025
ORLANDO FL
32891-8025
US

V. Phone/Fax

Practice location:
  • Phone: 305-321-8512
  • Fax:
Mailing address:
  • Phone: 305-321-8512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN901
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP1906072
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: