Individual
IVAN PERALTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2020 59TH ST W, BRADENTON, FL 34209-4604
(941) 792-6611
Mailing address
19525 SW 94TH PL, DUNNELLON, FL 34432-4111
(786) 543-6110
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN11037307
FL
Other
Enumeration date
01/14/2025
Last updated
01/31/2025
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