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General NPI Number Information
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NPI Number | 1194790162
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Entity Type | Individual
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Provider Name | JESUS L. DEL RISCO CRNA
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Gender | Male
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Dates
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Enumeration Date | 02/22/2006
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Last Update Date | 04/24/2016
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Provider Practice Location Address
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Address Line | 3100 S DOUGLAS RD
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City | CORAL GABLES
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State | FL
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Zip | 33134-6914
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Country | US
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Telephone | 305-662-2925
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Fax | 305-662-2341
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Provider Business Mailing Address
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Address Line | 9301 SW 84TH AVE
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City | MIAMI
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State | FL
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Zip | 33156-7574
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Country | US
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Telephone | 305-662-2925
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Fax | 305-662-2341
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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 | ARNP2512552
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License Number State | FL
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