Provider Demographics
NPI:1871583922
Name:DANNEMILLER, GERARD (CRNA)
Entity type:Individual
Prefix:
First Name:GERARD
Middle Name:
Last Name:DANNEMILLER
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8499 S TAMIAMI TRL
Mailing Address - Street 2:#4
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34238-2960
Mailing Address - Country:US
Mailing Address - Phone:941-350-4506
Mailing Address - Fax:
Practice Address - Street 1:8499 S TAMIAMI TRL
Practice Address - Street 2:#4
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34238-2960
Practice Address - Country:US
Practice Address - Phone:941-350-4506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-28
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3347092367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered