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General NPI Number Information
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NPI Number | 1093172306
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Entity Type | Individual
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Provider Name | ROBERT JOSEPH MADER JR. DNP-A, CRNA
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Gender | Male
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Dates
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Enumeration Date | 01/19/2016
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 1600 SW ARCHER RD
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City | GAINESVILLE
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State | FL
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Zip | 32610-2241
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Country | US
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Telephone | 352-273-6438
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Fax |
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Provider Business Mailing Address
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Address Line | 113 NE ALSBURY BLVD
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City | BURLESON
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State | TX
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Zip | 76028-2501
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Country | US
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Telephone | 352-572-1243
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 777895
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | APRN11038244
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License Number State | FL
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