Individual
MARVA LOUISVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
325 AVENUE B NW, WINTER HAVEN, FL 33881-4651
(863) 291-4000
Mailing address
PO BOX 917110, ORLANDO, FL 32891-7110
(800) 901-2102
(423) 892-5838
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1686352
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
302572100
—
FL
01
—
430048758
RAILROAD MEDICARE
FL
01
—
G1433
BCBS
FL
Enumeration date
05/31/2006
Last updated
05/21/2010
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