Provider Demographics
NPI:1144273525
Name:GILL, PAMELA A (CRNA)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:A
Last Name:GILL
Suffix:
Gender:F
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:GAP ANESTHESIA RESOURCES LLC
Mailing Address - Street 2:605 ISLEBAY DRIVE
Mailing Address - City:APOLLO
Mailing Address - State:FL
Mailing Address - Zip Code:33572-3336
Mailing Address - Country:US
Mailing Address - Phone:813-777-5559
Mailing Address - Fax:
Practice Address - Street 1:GAP ANESTHESIA RESOURCES LLC
Practice Address - Street 2:605 ISLEBAY DRIVE
Practice Address - City:APOLLO
Practice Address - State:FL
Practice Address - Zip Code:33572-3336
Practice Address - Country:US
Practice Address - Phone:813-777-5559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR100940367500000X
FLARNP9241575367500000X, 367H00000X
FL9241575367500000X
MDAC002829367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL7959784OtherAETNA PIN
FLG4009OtherBCBS
FL307697100Medicaid
FLU7680ZOtherMEDICARE GTBA REASSIGN
FLG4009OtherBCBS