Healthcare Provider Details

I. General information

NPI: 1659796092
Provider Name (Legal Business Name): STEPHEN VAN HOVIS CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2014
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-6533
US

IV. Provider business mailing address

PO BOX 650865
DALLAS TX
75265-0865
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-6438
  • Fax:
Mailing address:
  • Phone: 972-715-5000
  • Fax: 972-715-9976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN2753032
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP133588
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN2753032
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: