Healthcare Provider Details

I. General information

NPI: 1649888348
Provider Name (Legal Business Name): FRANK ISAAC UCROS CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2020
Last Update Date: 01/19/2022
Certification Date: 01/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 NW 79TH AVE
MIAMI FL
33122-1174
US

IV. Provider business mailing address

12290 NW 7TH TRL
MIAMI FL
33182-2408
US

V. Phone/Fax

Practice location:
  • Phone: 786-466-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11011434
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number9364508
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: