Individual provider Active NPI

Theresa L Bruno, CRNA

  • Certified Registered Nurse Anesthetist
  • Naples, FL
National Provider Identifier
1972584902
Registry record updated Oct 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
ARNP1631102 Issued in FL
Practice address
5301 Tallowood Way
Naples, FL 34116-5029
Phone
(239) 530-2580
NPI assigned
Nov 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X ARNP1631102 FL Primary

Addresses

Primary practice location

5301 Tallowood Way
Naples, FL 34116-5029

Mailing address

5301 Tallowood Way
Naples, FL 34116-5029
Phone (239) 530-2580

Other identifiers 2

IdentifierTypeStateIssuer
G2138OtherBC/BS
305229000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040318000300 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0345130837 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles (8 of 10)

OrganizationSpecialtyStatusNew patients
West Florida Anesthesia Associates LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2023 Accepting new patients
WM Darrell Gaskins LLC Current Accepting new patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2023 Accepting new patients
First Anesthesia Associates Inc Past Accepting new patients
Anesthesia & Pain Consultants of SW FL PastSince Jan 1, 2019 Accepting new patients
Outpatient Anesthesia of Southwest Florida Inc PastSince Jan 1, 2013 Accepting new patients
Anesthesia Management Services for Southwest Florida PA PastSince Oct 15, 2008 Accepting new patients
Collier Anesthesia PA Past Accepting new patients

Locations

665 Del Prado Blvd S
Cape Coral, FL 33990
Phone (239) 772-3636

6412 W Gulf To Lake Hwy
Crystal River, FL 34429
Phone (352) 563-0023

63 Barkley Cir
Ste 103
Fort Myers, FL 33907
Phone (239) 275-8882

4035 Evans Ave
Fort Myers, FL 33901
Phone (941) 939-4937

63 Barkley Cir
Ste 104
Fort Myers, FL 33907
Phone (239) 275-8452

8330 Lakewood Ranch Blvd
Lakewood Ranch, FL 34202
Phone (941) 666-8757

2335 Tamiami Trl N
Ste 304
Naples, FL 34103
Phone (239) 263-7750

1084 Goodlette Rd
Naples, FL 34102
Phone (239) 435-9330

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191974400000",
    "number": "1972584902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 TALLOWOOD WAY",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341165029",
            "telephone_number": "239-530-2580",
            "fax_number": "239-218-9142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 TALLOWOOD WAY",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341165029",
            "telephone_number": "239-530-2580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUNO",
        "first_name": "THERESA",
        "middle_name": "L",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-08",
        "last_updated": "2007-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "ARNP1631102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "G2138",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "305229000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.