MEDICARE: MR. JOSEPH FRANK LACAVA 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	ARNP1249132	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G0038Z	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1902911001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOSEPH FRANK LACAVA CRNA

Provider Business Mailing Address
First Line	:	PO BOX 1811
Second Line	:
City	:	ARCADIA
State	:	FL
Zip	:	34265-1811
Country	:	US
Telephone Number	:	863-993-0440
Fax Number	:	863-494-9273

Provider Business Practice Location Address
First Line	:	900 N ROBERTS AVE
Second Line	:
City	:	ARCADIA
State	:	FL
Zip	:	34266-8765
Country	:	US
Telephone Number	:	863-494-3535
Fax Number	:

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

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	11/20/2007

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