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General NPI Number Information
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NPI Number | 1982246328
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Entity Type | Individual
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Provider Name | AMY MARIE SURALIS RN
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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 | 07/13/2025
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Provider Practice Location Address
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Address Line | 3625 UNIVERSITY BLVD S
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City | JACKSONVILLE
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State | FL
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Zip | 32216-4207
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Country | US
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Telephone | 904-702-6111
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Fax |
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Provider Business Mailing Address
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Address Line | 4446 HENDRICKS AVE STE 366
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City | JACKSONVILLE
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State | FL
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Zip | 32207-6369
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Country | US
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Telephone | 813-217-2190
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN924226
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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 | 101666
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License Number State | NE
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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 | APRN11005568
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License Number State | FL
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