Healthcare Provider Details

I. General information

NPI: 1538419858
Provider Name (Legal Business Name): JOHN P FLOYD IV CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2012
Last Update Date: 09/16/2020
Certification Date: 09/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 TAMPA GENERAL CIR SUITE A327
TAMPA FL
33606-3571
US

IV. Provider business mailing address

421 SE ALFRED MARKHAM ST
LAKE CITY FL
32025-2204
US

V. Phone/Fax

Practice location:
  • Phone: 813-844-4396
  • Fax: 813-844-4972
Mailing address:
  • Phone: 386-697-1364
  • Fax: 888-370-3379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP 9336062
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: