Provider Demographics
NPI:1043267859
Name:FLOYD, DONALD (CRNA)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:
Last Name:FLOYD
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 550967
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33655-0967
Mailing Address - Country:US
Mailing Address - Phone:352-243-9114
Mailing Address - Fax:352-243-7822
Practice Address - Street 1:1381 CITRUS TOWER BLVD
Practice Address - Street 2:SUITE 4
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711
Practice Address - Country:US
Practice Address - Phone:352-243-9114
Practice Address - Fax:352-243-7822
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1712582367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL033638600Medicaid
FLG1205OtherBLUE CROSS BLUE SHIELD
FLG1205XMedicare ID - Type Unspecified
FL033638600Medicaid