Provider Demographics
NPI:1952375396
Name:HUFF, THOMAS W (CRNA)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:W
Last Name:HUFF
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:PO BOX 919374
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-9374
Mailing Address - Country:US
Mailing Address - Phone:866-444-0850
Mailing Address - Fax:941-269-4426
Practice Address - Street 1:1110 GULF BREEZE PKWY
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32561-4884
Practice Address - Country:US
Practice Address - Phone:850-469-2044
Practice Address - Fax:850-434-4683
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1092269367500000X
FLAPRN11030921367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009974040Medicaid
ALCN0216OtherMEDICARE TRAVELERS
AL105337Medicaid
AL051551385Medicare ID - Type Unspecified
AL009974040Medicaid