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Individual

GREGORY S. MCDUFFIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
400 N MILLS AVE, ORLANDO, FL 32803-5722
(407) 581-9180
(407) 926-9173
Mailing address
PO BOX 4918, ORLANDO, FL 32802-4918
(407) 581-9180
(407) 926-9173

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP3289102
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0038284 00
FL
01
G00S2
BCBS
FL
01
P01045893
RAILROAD MEDICARE
01
XXX-XX-4833
CHAMPUS TRICARE - SOUTH REGION
Enumeration date
06/20/2011
Last updated
07/31/2013
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