MEDICARE: SUSAN DOZIER CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	ARNP0455362	FL

General Provider Information

NPI Number	:	1730138959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN DOZIER CRNA

Provider Business Mailing Address
First Line	:	5448 ATLANTIC VW
Second Line	:
City	:	ST AUGUSTINE
State	:	FL
Zip	:	32080-7148
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3901 UNIVERSITY BLVD S
Second Line	:	SUITE 121
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-4377
Country	:	US
Telephone Number	:	904-421-2119
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2006
Last Update Date	:	07/12/2007

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Directions to “ SUSAN DOZIER CRNA” Practice Location

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