Healthcare Provider Details

I. General information

NPI: 1912228826
Provider Name (Legal Business Name): CASEY SCANDURA CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CASEY CASSON

II. Dates (important events)

Enumeration Date: 06/15/2010
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

62 COLUMBIA ST
ORLANDO FL
32806-1115
US

IV. Provider business mailing address

62 COLUMBIA ST
ORLANDO FL
32806-1115
US

V. Phone/Fax

Practice location:
  • Phone: 407-712-8131
  • Fax: 321-843-2196
Mailing address:
  • Phone: 407-712-8131
  • Fax: 321-843-2196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP9170408
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: