MEDICARE: MARY K SETTEMBRINI 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	ARNP893902	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G0077	OTHER		BCBS

General Provider Information

NPI Number	:	1972558294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY K SETTEMBRINI CRNA

Provider Business Mailing Address
First Line	:	5450 OLD OCEAN BLVD
Second Line	:	#4
City	:	OCEAN RIDGE
State	:	FL
Zip	:	33435-7072
Country	:	US
Telephone Number	:	561-702-6360
Fax Number	:

Provider Business Practice Location Address
First Line	:	5450 OLD OCEAN BLVD
Second Line	:	#4
City	:	OCEAN RIDGE
State	:	FL
Zip	:	33435
Country	:	US
Telephone Number	:	561-702-6360
Fax Number	:

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

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	03/03/2009

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