Healthcare Provider Details

I. General information

NPI: 1639518244
Provider Name (Legal Business Name): ADAM S. BILLEN CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2013
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

924 N MAGNOLIA AVE SUITE 202 #1192
ORLANDO FL
32803-3220
US

IV. Provider business mailing address

924 N MAGNOLIA AVE SUITE 202 #1192
ORLANDO FL
32803-3220
US

V. Phone/Fax

Practice location:
  • Phone: 407-733-7403
  • Fax:
Mailing address:
  • Phone: 407-733-7403
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP9237872
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: