Individual
DAVID B KOONTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2 COLUMBIA DR, SUITE A327, TAMPA, FL 33606-3508
(813) 844-4396
(813) 844-4972
Mailing address
2 COLUMBIA DR, SUITE A327, TAMPA, FL 33606-3508
(813) 844-4396
(813) 844-4972
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
9244008
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
308193100
—
FL
01
—
G4161
BCBS
FL
01
—
P00391888
MEDICARE RAILROAD
FL
Enumeration date
12/08/2006
Last updated
06/17/2008
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