Provider Demographics
NPI:1841399649
Name:REED, GAYLE (CRNA)
Entity type:Individual
Prefix:
First Name:GAYLE
Middle Name:
Last Name:REED
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 1:1132 COUNTY ROAD, HWY 475, STE 100
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:FL
Mailing Address - Zip Code:34744
Mailing Address - Country:US
Mailing Address - Phone:352-427-0794
Mailing Address - Fax:
Practice Address - Street 1:1132 COUNTY ROAD, HWY 475, STE 100
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:FL
Practice Address - Zip Code:34744
Practice Address - Country:US
Practice Address - Phone:352-427-0794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP679242367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL305764000Medicaid
FLP00217378OtherRAILROAD MEDICARE
FLG0043OtherBLUE CROSS BLUE SHIELD
FLG0043OtherBLUE CROSS BLUE SHIELD