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General NPI Number Information
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NPI Number | 1245374610
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Entity Type | Individual
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Provider Name | PROMISE G. TOBY CRNA
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Gender | Male
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Dates
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Enumeration Date | 02/17/2007
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Last Update Date | 04/16/2013
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Provider Practice Location Address
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Address Line | 3309 SW 34TH CIR STE 101
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City | OCALA
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State | FL
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Zip | 34474-3392
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Country | US
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Telephone | 352-237-2400
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Fax |
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Provider Business Mailing Address
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Address Line | 2711 SE 15TH ST
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City | OCALA
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State | FL
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Zip | 34471-4724
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Country | US
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Telephone | 352-732-6189
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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 | ARNP 9191766
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License Number State | FL
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