Individual
ARLES L RUSTIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
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
26NO09431300
NJ
367500000X
Certified Registered Nurse Anesthetist
APRN9315729
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9315729
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004332800
—
FL
01
—
FV187Y
MEDICARE
FL
01
—
G00VC
BCBS
FL
Enumeration date
06/20/2005
Last updated
03/11/2022
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