Healthcare Provider Details

I. General information

NPI: 1538540943
Provider Name (Legal Business Name): CARLA PEREZ-COLON CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2015
Last Update Date: 06/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N. WOLFE ST., BLALOCK 1410 JOHN HOPKINS HOSPITAL / DIVISION OF NURSE ANESTHESIA
BALTIMORE MD
21287
US

IV. Provider business mailing address

585 OVER RIDGE DR
FREDERICK MD
21703-6037
US

V. Phone/Fax

Practice location:
  • Phone: 443-287-2937
  • Fax:
Mailing address:
  • Phone: 786-223-5046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number9293699
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: