Individual
MR. KEITH LATASIEWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP-CRNA
Contact information
Practice address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(190) 495-3200
Mailing address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN11005942
FL
Other
Enumeration date
01/23/2020
Last updated
07/29/2021
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