Provider Demographics
NPI:1245374610
Name:TOBY, PROMISE G (CRNA)
Entity type:Individual
Prefix:MR
First Name:PROMISE
Middle Name:G
Last Name:TOBY
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 1:2711 SE 15TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-4724
Mailing Address - Country:US
Mailing Address - Phone:352-732-6189
Mailing Address - Fax:
Practice Address - Street 1:3309 SW 34TH CIR
Practice Address - Street 2:STE 101
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-3392
Practice Address - Country:US
Practice Address - Phone:352-237-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-17
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9191766367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL592689712Other6
FL97302Other4
FLN146227Other1
FL062763100Medicaid
FL97302Medicare ID - Type Unspecified5
FL592689712Other6