Healthcare Provider Details

I. General information

NPI: 1265764518
Provider Name (Legal Business Name): BRIDGET TERRANELLA GUZZARDO CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRIDGET TERRANELLA CRNA

II. Dates (important events)

Enumeration Date: 02/10/2010
Last Update Date: 10/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 TAMPA GENERAL CIR SUITE A327
TAMPA FL
33606-3571
US

IV. Provider business mailing address

400 N ASHLEY DR SUITE 1625
TAMPA FL
33602-4300
US

V. Phone/Fax

Practice location:
  • Phone: 813-844-7677
  • Fax: 813-844-4972
Mailing address:
  • Phone: 813-844-4434
  • Fax: 813-844-4972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP9190958
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: