Individual
HENRY FONTILLAS PATALINGHUG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-6511
(352) 273-6438
Mailing address
PO BOX 44008, UFJP - PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
(904) 244-3199
(904) 244-3425
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN3318112
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003131804B
—
GA
05
—
008339000
—
FL
Enumeration date
02/21/2013
Last updated
08/23/2023
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