Individual
GISELLA LACAYO DETTBARN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
9333 SW 152ND ST, PALMETTO BAY, FL 33157-1778
(305) 251-2500
Mailing address
9333 SW 152ND ST, PALMETTO BAY, FL 33157-1778
(305) 251-2500
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9204956
FL
367500000X
Certified Registered Nurse Anesthetist
RN9204956
FL
Other
Enumeration date
12/23/2010
Last updated
08/04/2015
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