Gibbons, Michael T

Gibbons, Michael T is an individual health care provider with primary practice located at 421 Se Osceola St Ste 3, Stuart FL 34994-2505. 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. Gibbons, Michael T can be contacted via phone (772) 286-0338.

Contact Information

Primary practice address
421 Se Osceola St Ste 3 Stuart FL 34994-2505
Phone: (772) 286-0338
Fax: (772) 287-1139
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 146302 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X ARNP2948472 Florida

Profile Details

NPI number 1184693574
LBN Legal business name Gibbons, Michael T
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 16th, 2006
Last updated Jul 15th, 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 1184693574 NPPES
Tennessee Other 146302 NURSING LICENSE #
Tennessee Other AQ780Z NURSING LICENSE #
Tennessee Other G4647 NURSING LICENSE #
Tennessee MEDICAID 0004722-00 NURSING LICENSE #

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