Healthcare Provider Details

I. General information

NPI: 1568466449
Provider Name (Legal Business Name): ROBERT MICHAEL ADAMS CRNA, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2005
Last Update Date: 08/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2784 ISLAND POND LN ANESTHESIA STAT LLC
NAPLES FL
34119-7526
US

IV. Provider business mailing address

2784 ISLAND POND LN
NAPLES FL
34119-7526
US

V. Phone/Fax

Practice location:
  • Phone: 215-519-3384
  • Fax: 215-428-1237
Mailing address:
  • Phone: 215-519-3384
  • Fax: 215-428-1237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP9252584
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN342424L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPN 26NJ00213800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: