MEDICARE: HILLARY MENDELSOHN 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	ARNP1633562	FL

General Provider Information

NPI Number	:	1265491088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HILLARY MENDELSOHN CRNA

Provider Business Mailing Address
First Line	:	C/O ANESCO ANESTHESIA ASSOCIATES INC
Second Line	:	4631 NW 31ST AVENUE #127
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309
Country	:	US
Telephone Number	:	954-485-5666
Fax Number	:	954-484-1651

Provider Business Practice Location Address
First Line	:	C/O NORTH RIDGE MEDICAL CENTER
Second Line	:	5757 NORTH DIXIE HIGHWAY
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33334
Country	:	US
Telephone Number	:	954-776-6000
Fax Number	:

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

Provider Enumeration Date	:	03/21/2006
Last Update Date	:	07/08/2007

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