Individual
KC MAX TERVIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
52 UNDERWOOD ST, ORLANDO, FL 32806-1110
(321) 841-5210
Mailing address
295 NE IVANHOE BLVD APT 816, ORLANDO, FL 32804-6494
(954) 740-0064
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN11032828
FL
Other
Enumeration date
05/29/2023
Last updated
05/30/2024
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