MEDICARE: MARTIN JOSEPH CARNEY 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	ARNP 1831672	FL
2	367500000X	Certified Registered Nurse Anesthetist	RN229116L	PA
3	367500000X	Certified Registered Nurse Anesthetist	APN0000009971	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G1039	OTHER	FL	BC/BS

General Provider Information

NPI Number	:	1942291174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTIN JOSEPH CARNEY CRNA

Provider Business Mailing Address
First Line	:	1436 DAVENPORT DR
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34655-4224
Country	:	US
Telephone Number	:	727-372-6991
Fax Number	:	727-372-6991

Provider Business Practice Location Address
First Line	:	6600 MADISON ST
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34652-1971
Country	:	US
Telephone Number	:	727-842-8486
Fax Number	:

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

Provider Enumeration Date	:	11/05/2005
Last Update Date	:	01/16/2008

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Directions to “ MARTIN JOSEPH CARNEY CRNA” Practice Location

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