Individual
CHARLES GRESKO-MCTIERNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3435 PINEHURST AVE, ORLANDO, FL 32804-4049
(407) 801-3888
Mailing address
671 GAMEWELL AVE, MAITLAND, FL 32751-4401
(850) 556-3278
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9463014
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
11026479
FL
Other
Enumeration date
04/06/2021
Last updated
08/14/2023
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