Healthcare Provider Details

I. General information

NPI: 1053806786
Provider Name (Legal Business Name): JASON FRANKLUND CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2018
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6600 UNIVERSITY PKWY
SARASOTA FL
34240-9037
US

IV. Provider business mailing address

2391 CARAWAY DR
VENICE FL
34292-4174
US

V. Phone/Fax

Practice location:
  • Phone: 941-444-5510
  • Fax:
Mailing address:
  • Phone: 509-424-0435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11012279
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: