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Individual

JERRY CHRISTMAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
4048 EVANS AVE, SUITE 303, FORT MYERS, FL 33901-9322
(239) 332-5344
(239) 332-7246
Mailing address
640 BAYSHORE DR, TARPON SPRINGS, FL 34689-2456
(727) 934-2856
(727) 934-2856

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP3190942
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
306725400
FL
01
G2287
BCBS
FL
Enumeration date
10/27/2005
Last updated
07/21/2008
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