Healthcare Provider Details

I. General information

NPI: 1356680649
Provider Name (Legal Business Name): DOMINIQUE BIEN-AIME BARCENA CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DOMINIQUE BIEN-AIME CRNA

II. Dates (important events)

Enumeration Date: 02/06/2013
Last Update Date: 12/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 BUTTONWOOD AVE
MIRAMAR FL
33025-2417
US

IV. Provider business mailing address

7600 W SUNRISE BLVD MAIL STOP-PL-31
PLANTATION FL
33322-4115
US

V. Phone/Fax

Practice location:
  • Phone: 954-793-7790
  • Fax:
Mailing address:
  • Phone: 954-838-2371
  • Fax: 954-851-1746

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number9162833
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP9162833
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: