Provider Demographics
NPI:1336113083
Name:GO, NENITA M (CRNA)
Entity Type:Individual
Prefix:
First Name:NENITA
Middle Name:M
Last Name:GO
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 1:801 S OLIVE AVE
Mailing Address - Street 2:SUITE 215
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-6120
Mailing Address - Country:US
Mailing Address - Phone:561-835-1155
Mailing Address - Fax:
Practice Address - Street 1:801 S OLIVE AVE
Practice Address - Street 2:SUITE 215
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-6120
Practice Address - Country:US
Practice Address - Phone:561-371-8639
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1145112367500000X
MA268790367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL430074238OtherRR MEDICARE
FLG1924OtherBCBS OF FLORIDA
FL301418500Medicaid
FL301418500Medicaid
MANA1190Medicare PIN
FLG1924VMedicare PIN
FLG1924UMedicare PIN