Healthcare Provider Details

I. General information

NPI: 1154415420
Provider Name (Legal Business Name): SETH WEISER CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 05/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3854 TORREY PINES BLVD
SARASOTA FL
34238-2831
US

IV. Provider business mailing address

3854 TORREY PINES BLVD
SARASOTA FL
34238-2831
US

V. Phone/Fax

Practice location:
  • Phone: 941-724-7384
  • Fax: 941-343-3967
Mailing address:
  • Phone: 941-724-7384
  • Fax: 941-343-3967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP1380852
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: