Healthcare Provider Details

I. General information

NPI: 1760880694
Provider Name (Legal Business Name): ANDREA AGOSTINELLI SALARI CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANDREA AGOSTINELLI CRNA

II. Dates (important events)

Enumeration Date: 12/09/2014
Last Update Date: 11/09/2023
Certification Date: 11/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 PINELLAS ST
CLEARWATER FL
33756-3804
US

IV. Provider business mailing address

7700 W SUNRISE BLVD 2ND FL - MAILSTOP PL-14
PLANTATION FL
33322-4113
US

V. Phone/Fax

Practice location:
  • Phone: 727-462-7308
  • Fax: 954-616-3655
Mailing address:
  • Phone: 954-939-2371
  • Fax: 954-851-1746

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9285665
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP9285665
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: