Derise, Gerald

Derise, Gerald is an individual health care provider with primary practice located at 325 Avenue B Nw , Winter Haven FL 33881-4651. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Derise, Gerald can be contacted via phone (863) 291-4000.

Contact Information

Primary practice address
325 Avenue B Nw Winter Haven FL 33881-4651
Phone: (863) 291-4000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 573282 Florida

Profile Details

NPI number 1720025935
LBN Legal business name Derise, Gerald
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2006
Last updated May 24th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720025935 NPPES
Florida Other P00274577 RAILROAD MEDICARE
Florida MEDICAID 306429800 RAILROAD MEDICARE
Florida Other G0579 RAILROAD MEDICARE

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