Provider Demographics
NPI:1245327576
Name:FLOYD, MICHELLE RENEE (CRNA ARNP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:RENEE
Last Name:FLOYD
Suffix:
Gender:F
Credentials:CRNA ARNP
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:RENEE
Other - Last Name:SITEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16177 HAMLIN BLVD
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-2859
Mailing Address - Country:US
Mailing Address - Phone:561-312-4490
Mailing Address - Fax:
Practice Address - Street 1:60 FAIRWAY LN
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-1215
Practice Address - Country:US
Practice Address - Phone:561-333-8162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2877412207L00000X
FLARNP2877412367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3087948 00Medicaid