Basic Information
Provider Information
NPI: 1801567185
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GAO
FirstName: MING
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
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OtherCredential:  
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Mailing Information
Address1: 851 TRAFALGAR CT STE 200E
Address2:  
City: MAITLAND
State: FL
PostalCode: 327517420
CountryCode: US
TelephoneNumber: 4076670444
FaxNumber:  
Practice Location
Address1: 601 E ROLLINS ST DEPT OF
Address2:  
City: ORLANDO
State: FL
PostalCode: 328031248
CountryCode: US
TelephoneNumber: 4076670444
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/25/2021
LastUpdateDate: 07/06/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/06/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WC0200XRN9436886FLN Nursing Service ProvidersRegistered NurseCritical Care Medicine
367500000XAPRN11020404FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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