| Justin Gary Broadhead, CRNA | |
|
21298 Olean Blvd, Port Charlotte, FL 33952-6705 | |
| (941) 629-1181 | |
| Not Available |
| Full Name | Justin Gary Broadhead |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 8 Years |
| Location | 21298 Olean Blvd, Port Charlotte, Florida |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477076107 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 9397757 (Florida) | Primary |
| 367500000X | Nurse Anesthetist, Certified Registered | 1011922 (Texas) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Corpus Christi Medical Center,the | Corpus christi, TX | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Northstar Anesthesia Iii Pa | 0042630501 | 347 |
| Entity Name | Northstar Anesthesia Ii Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477066405 PECOS PAC ID: 2365701737 Enrollment ID: O20180110000102 |
| Entity Name | Northstar Anesthesia Iii Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356968952 PECOS PAC ID: 0042630501 Enrollment ID: O20201022000080 |
| Mailing Address | Practice Location Address |
|---|---|
| Justin Gary Broadhead, CRNA 1 Tampa General Cir Ste A327, Tampa, FL 33606-3571 Ph: (813) 844-4116 | Justin Gary Broadhead, CRNA 21298 Olean Blvd, Port Charlotte, FL 33952-6705 Ph: (941) 629-1181 |
Mrs. Lauren Arthur, CRNA, ARNP Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2500 Harbor Blvd, Port Charlotte, FL 33952 Phone: 941-766-4125 Fax: 941-766-4101 | |
Martha Gaudiel, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 21298 Olean Blvd, Port Charlotte, FL 33949 Phone: 941-629-1181 Fax: 941-624-6020 | |
Kouji J. Bowser, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2500 Harbor Blvd, Port Charlotte, FL 33952 Phone: 941-766-4125 Fax: 941-766-4101 | |
Blaine E Griffiths Iii, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 2500 Harbor Blvd, Port Charlotte, FL 33952 Phone: 941-766-4125 | |
Daniel Carl Peterson, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2500 Harbor Blvd, Port Charlotte, FL 33952 Phone: 941-766-4125 Fax: 941-766-4101 | |
James Hutchins, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 21298 Olean Blvd, Port Charlotte, FL 33949 Phone: 941-629-1181 Fax: 941-624-6020 | |
Karen Kalbfeld, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 327 Kindred Blvd, Port Charlotte, FL 33954 Phone: 941-624-5220 |