Healthcare Provider Details

I. General information

NPI: 1366882284
Provider Name (Legal Business Name): CAROLYN GOSCH HERMAN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAROLYN GOSCH HERMAN

II. Dates (important events)

Enumeration Date: 06/25/2013
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83 W MILLER ST
ORLANDO FL
32806-2031
US

IV. Provider business mailing address

587 KEYHOLD LOOP
APOPKA FL
32712-2745
US

V. Phone/Fax

Practice location:
  • Phone: 321-843-9792
  • Fax: 954-851-1746
Mailing address:
  • Phone: 407-687-5042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN9162815
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1153891
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: