Healthcare Provider Details

I. General information

NPI: 1992286355
Provider Name (Legal Business Name): CRAMER SCOTT HURT CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2018
Last Update Date: 03/10/2020
Certification Date: 03/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 TAMPA GENERAL CIR
TAMPA FL
33606-3571
US

IV. Provider business mailing address

400 N ROME AVE UNIT 2129
TAMPA FL
33606-1272
US

V. Phone/Fax

Practice location:
  • Phone: 903-658-7778
  • Fax:
Mailing address:
  • Phone: 903-658-7778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP143878
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11000628
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9456287
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number857418
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: