Healthcare Provider Details

I. General information

NPI: 1306379995
Provider Name (Legal Business Name): MICHAEL A. LOMBARDO CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2017
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

83 W MILLER ST
ORLANDO FL
32806-2031
US

IV. Provider business mailing address

1323 SE 17TH ST UNIT 90211
FT LAUDERDALE FL
33316-1707
US

V. Phone/Fax

Practice location:
  • Phone: 321-843-1110
  • Fax:
Mailing address:
  • Phone: 407-963-6836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP9349494
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: