Individual
MR. EDDY D BURGESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
8965 EASTON RIVER DR, JACKSONVILLE, FL 32257-1714
(904) 588-4347
(904) 737-4879
Mailing address
851 TRAFALGAR CT., SUITE 200E, MAITLAND, FL 32751
(407) 667-0444
(407) 667-4338
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9167702
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00912458A
—
GA
05
—
303170500
—
FL
01
—
G2681
BLUE CROSS BLUE SHIELD
FL
Enumeration date
04/25/2006
Last updated
07/11/2017
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