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Individual

MICHAEL C. MAUNEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
4901 GRANDE DR, PENSACOLA, FL 32504-5935
(850) 477-7042
(850) 474-9060
Mailing address
4901 GRANDE DR, PENSACOLA, FL 32504-5935
(850) 477-7042
(850) 474-9060

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9301405
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001858800
FL
05
116391
AL
01
593-04259
BLUE CROSS BLUE SHIELD
AL
01
G007H
BLUE CROSS BLUE SHIELD
FL
01
P00838942
MEDICARE RAILROAD
Enumeration date
01/25/2010
Last updated
11/11/2011
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