| Terry L Bax, CRNA | |
|
421 Se Alfred Markham St, Lake City, FL 32025-2204 | |
| (386) 697-1364 | |
| (888) 370-3379 |
| Full Name | Terry L Bax |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 421 Se Alfred Markham St, Lake City, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154315612 | NPI | - | NPPES |
| 301528900 | Medicaid | FL | |
| G1977 | Other | FL | BLUE SHIELD PROV # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | ARNP3002322 (Florida) | Primary |
| Entity Name | Somnicare Anesthesia & Spine Intervention Specialist, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962712794 PECOS PAC ID: 4688859960 Enrollment ID: O20110502000379 |
| Mailing Address | Practice Location Address |
|---|---|
| Terry L Bax, CRNA 421 Se Alfred Markham St, Lake City, FL 32025-2204 Ph: (386) 697-1364 | Terry L Bax, CRNA 421 Se Alfred Markham St, Lake City, FL 32025-2204 Ph: (386) 697-1364 |
Lewis Mitchell Sharp, ARNP, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 198 Sw Governors Gln, Lake City, FL 32024 Phone: 386-623-2899 | |
Ms. Pamela Nichols Robinson, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 404 Nw Hall Of Fame Dr, Lake City, FL 32055 Phone: 386-487-3930 | |
Celeste B Webb, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 421 Se Alfred Markham St, Lake City, FL 32025 Phone: 386-697-1364 Fax: 888-370-3379 | |
Eileen Molyet, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 421 Se Alfred Markham St, Lake City, FL 32025 Phone: 386-697-1364 Fax: 888-370-3379 | |
William S Jones, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 421 Se Alfred Markham St, Lake City, FL 32025 Phone: 386-697-1364 Fax: 888-370-3379 | |
Miss Mary Shimko, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 421 Se Alfred Markham St, Lake City, FL 32025 Phone: 386-697-1364 Fax: 888-370-3379 |