Individual
JOLYN MARIE GONTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1000 MAR WALT DR, FORT WALTON BEACH, FL 32547-6708
(850) 862-1111
Mailing address
7700 W SUNRISE BLVD, PLANTATION, FL 33322-4113
(954) 939-5554
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024186641
VA
367500000X
Certified Registered Nurse Anesthetist
APRN11000725
FL
367500000X
Certified Registered Nurse Anesthetist
C-APN.0004013-C-CRNA
CO
Other
Enumeration date
01/03/2019
Last updated
07/10/2025
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