Healthcare Provider Details

I. General information

NPI: 1972007540
Provider Name (Legal Business Name): MICHAEL JOSEPH OCCHIPINTI DNAP, MNA, CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2018
Last Update Date: 05/07/2024
Certification Date: 05/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 SAN PABLO RD
JACKSONVILLE FL
32224
US

IV. Provider business mailing address

4500 SAN PABLO RD
JACKSONVILLE FL
32224-1865
US

V. Phone/Fax

Practice location:
  • Phone: 904-953-2000
  • Fax:
Mailing address:
  • Phone: 904-953-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number0224189489
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number22009
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11016887
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: