Individual
JOHN D MUNDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4500 SAN PABLO RD S STE 20, JACKSONVILLE, FL 32224
(909) 495-3200
(763) 450-3986
Mailing address
4500 SAN PABLO RD S STE 20, JACKSONVILLE, FL 32224-1865
(909) 495-3200
(763) 450-3986
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN11001687
FL
367500000X
Certified Registered Nurse Anesthetist
R146429-2
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
367107100
—
MN
Enumeration date
05/25/2006
Last updated
01/05/2021
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