Koressel, Robert G.

Koressel, Robert G. is an individual health care provider with primary practice located at 4901 Grande Dr , Pensacola FL 32504-5935. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Koressel, Robert G. can be contacted via phone (850) 477-7042.

Contact Information

Primary practice address
4901 Grande Dr Pensacola FL 32504-5935
Phone: (850) 477-7042
Fax: (850) 474-9060
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X ARNP1521992 Florida

Profile Details

NPI number 1366444796
LBN Legal business name Koressel, Robert G.
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 15th, 2005
Last updated Nov 17th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366444796 NPPES
Florida Other 430068703 RAILROAD MEDICARE
Florida MEDICAID 303902100 RAILROAD MEDICARE
Florida MEDICAID 009958570 RAILROAD MEDICARE
Florida Other G0474 RAILROAD MEDICARE
Florida Other 59048146 RAILROAD MEDICARE

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