MEDICARE: PATRICK WILLIAM ED MCCABE CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	ARNP 2129302	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G3160	OTHER	FL	FL BCBS PROVIDER #
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063408201
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK WILLIAM ED MCCABE CRNA

Provider Business Mailing Address
First Line	:	12400 101ST ST
Second Line	:
City	:	LARGO
State	:	FL
Zip	:	33773-1934
Country	:	US
Telephone Number	:	727-581-5948
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 COLUMBIA DR
Second Line	:	SUITE A327
City	:	TAMPA
State	:	FL
Zip	:	33606-3508
Country	:	US
Telephone Number	:	813-844-4434
Fax Number	:	813-844-4467

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	07/08/2007

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