Healthcare Provider Details

I. General information

NPI: 1952375396
Provider Name (Legal Business Name): THOMAS W HUFF CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 03/08/2024
Certification Date: 03/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1110 GULF BREEZE PKWY
GULF BREEZE FL
32561-4884
US

IV. Provider business mailing address

PO BOX 919374
ORLANDO FL
32891-9374
US

V. Phone/Fax

Practice location:
  • Phone: 850-469-2044
  • Fax: 850-434-4683
Mailing address:
  • Phone: 866-444-0850
  • Fax: 941-269-4426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1092269
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11030921
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: