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General NPI Number Information
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NPI Number | 1528005857
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Entity Type | Individual
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Provider Name | STEVEN G COOPER CRNA
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Gender | Male
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 06/08/2011
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Provider Practice Location Address
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Address Line | 1874 SE PORT ST LUCIE BLVD
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-5545
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Country | US
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Telephone | 772-337-7676
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Fax | 772-337-9034
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Provider Business Mailing Address
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Address Line | 3981 SW SAINT LUCIE LN
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City | PALM CITY
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State | FL
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Zip | 34990-3849
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Country | US
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Telephone |
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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 | ARNP3280702
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License Number State | FL
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