Healthcare Provider Details

I. General information

NPI: 1437615465
Provider Name (Legal Business Name): MARIA NOEL KLAMMER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2019
Last Update Date: 02/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1395 S PINELLAS AVE
TARPON SPRINGS FL
34689-3790
US

IV. Provider business mailing address

1321 HILLSIDE DR
TARPON SPRINGS FL
34689-2011
US

V. Phone/Fax

Practice location:
  • Phone: 727-507-3600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11001473
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: