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NPI Code Detail

MEDICARE: MISS JENNIFER RAE TROCK DNP, CRNA

MEDICARE: MISS JENNIFER RAE TROCK DNP, 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
1367500000XCertified Registered Nurse AnesthetistRN9361313FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275194409
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS JENNIFER RAE TROCK DNP, CRNA
Provider Business Mailing Address
First Line : 3131 NE 188TH ST APT 2805
Second Line :
City : AVENTURA
State : FL
Zip : 33180-2777
Country : US
Telephone Number : 440-796-7815
Fax Number :
Provider Business Practice Location Address
First Line : 5030 BRUNSON DR
Second Line :
City : CORAL GABLES
State : FL
Zip : 33146-2412
Country : US
Telephone Number : 305-284-3666
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2019
Last Update Date : 06/27/2019

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