Healthcare Provider Details

I. General information

NPI: 1538682919
Provider Name (Legal Business Name): ERIC MICHAEL HOUGH CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2017
Last Update Date: 03/02/2021
Certification Date: 03/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5950 NW 96TH LN
OCALA FL
34482-7312
US

IV. Provider business mailing address

5950 NW 96TH LN
OCALA FL
34482-7312
US

V. Phone/Fax

Practice location:
  • Phone: 352-598-4422
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11005352
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number116973
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number738689
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: