Individual
DONALD FILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
12902 USF MAGNOLIA DR, TAMPA, FL 33612-9416
(813) 745-8486
Mailing address
12738 TAR FLOWER DR, TAMPA, FL 33626-2340
(248) 202-5913
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
4704172755
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP 9230423
FL
367500000X
Certified Registered Nurse Anesthetist
RN 133357
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G3925
BCBS
FL
Enumeration date
04/26/2006
Last updated
07/08/2007
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