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NPI Code Detail

MEDICARE: MS. AMANDA RAE ZAKRAJSEK APRN CRNA

MEDICARE: MS. AMANDA RAE ZAKRAJSEK APRN 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 Anesthetist127963OH

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 : 1295368215
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. AMANDA RAE ZAKRAJSEK APRN CRNA
Provider Business Mailing Address
First Line : 533 QUAIL DOWN DR
Second Line :
City : DEBARY
State : FL
Zip : 32713-4506
Country : US
Telephone Number : 440-547-6638
Fax Number :
Provider Business Practice Location Address
First Line : 92 W MILLER ST
Second Line :
City : ORLANDO
State : FL
Zip : 32806-2036
Country : US
Telephone Number : 321-843-8851
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/18/2020
Last Update Date : 02/18/2020

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