Healthcare Provider Details

I. General information

NPI: 1548523129
Provider Name (Legal Business Name): REBECCA FOSKET CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2012
Last Update Date: 07/11/2023
Certification Date: 07/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5555 PONCE DE LEON BLVD
CORAL GABLES FL
33146-2513
US

IV. Provider business mailing address

5555 PONCE DE LEON BLVD
CORAL GABLES FL
33146-2513
US

V. Phone/Fax

Practice location:
  • Phone: 305-689-0695
  • Fax: 305-545-6501
Mailing address:
  • Phone: 305-689-0695
  • Fax: 305-545-6501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11022253
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: