Healthcare Provider Details

I. General information

NPI: 1932507936
Provider Name (Legal Business Name): MICHELLE MARCIANO CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2014
Last Update Date: 12/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 N STATE ROAD 7
MARGATE FL
33063-5727
US

IV. Provider business mailing address

5642 NW 39TH AVE
COCONUT CREEK FL
33073-4125
US

V. Phone/Fax

Practice location:
  • Phone: 954-601-8094
  • Fax:
Mailing address:
  • Phone: 954-242-8221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP9310973
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: