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General NPI Number Information
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NPI Number | 1154656049
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Entity Type | Individual
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Provider Name | MANUEL A FALCON CRNA
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Gender | Male
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Dates
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Enumeration Date | 10/09/2009
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Last Update Date | 09/23/2016
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Provider Practice Location Address
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Address Line | 24 HOSPITAL LN
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City | CALAIS
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State | ME
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Zip | 04619-1329
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Country | US
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Telephone | 207-454-7521
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Fax |
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Provider Business Mailing Address
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Address Line | 601 NW WAVERLY CIR
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City | PORT ST LUCIE
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State | FL
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Zip | 34983-3410
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Country | US
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Telephone | 860-478-9296
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | E59980
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RNA163034
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License Number State | ME
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | ARNP 9339865
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License Number State | FL
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