Individual
DOUGLAS HOWARD PAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1350 HICKORY ST, MELBOURNE, FL 32901-3224
(321) 434-7000
Mailing address
407 HIGHWAY A1A APT 452, SATELLITE BEACH, FL 32937-2329
(910) 792-0199
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
168953
NC
367500000X
Certified Registered Nurse Anesthetist
168953
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9283899
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000674900
—
FL
Enumeration date
06/16/2006
Last updated
01/17/2017
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