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Individual

MR. MICHAEL R. HERNICZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
4759 LAKEVIEW DR, SUITE 103, SEBRING, FL 33870-2005
(863) 402-5600
Mailing address
PO BOX 187, WINFIELD, TN 37892-0187
(423) 569-6614

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
03992
OH
367500000X
Certified Registered Nurse Anesthetist
4704104020
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP985972
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4704104020
LICENSE NUMBER
MI
Enumeration date
05/24/2006
Last updated
12/07/2015
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