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General NPI Number Information
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NPI Number | 1699317156
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Entity Type | Individual
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Provider Name | JOEY SUN PARK CRNA
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Gender | Female
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Dates
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Enumeration Date | 10/16/2019
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 200 AVENUE F NE
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City | WINTER HAVEN
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State | FL
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Zip | 33881-4131
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Country | US
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Telephone | 940-703-4607
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Fax | 817-207-4182
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Provider Business Mailing Address
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Address Line | 2995 DREW ST
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City | CLEARWATER
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State | FL
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Zip | 33759-3012
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Country | US
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Telephone | 727-281-9065
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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 | 11007352
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License Number State | FL
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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 | 95001336
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License Number State | CA
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