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NPI Code Detail

MEDICARE: JOHN DUNLAP CRNA

MEDICARE: JOHN DUNLAP CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse AnesthetistAN177814AFL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417959172
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN DUNLAP CRNA
Provider Business Mailing Address
First Line : PO BOX 861774
Second Line :
City : ORLANDO
State : FL
Zip : 32886-1774
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2001 KINGSLEY AVE
Second Line :
City : ORANGE PARK
State : FL
Zip : 32073-5148
Country : US
Telephone Number : 904-421-2119
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2005
Last Update Date : 07/08/2007

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