MEDICARE: MRS. DIANE LITWAK PIKOS 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	ARNP1353272	FL

General Provider Information

NPI Number	:	1316964026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DIANE LITWAK PIKOS CRNA

Provider Business Mailing Address
First Line	:	1235 N FLORIDA AVE
Second Line	:
City	:	TARPON SPRINGS
State	:	FL
Zip	:	34689-2003
Country	:	US
Telephone Number	:	727-937-7220
Fax Number	:	727-937-8552

Provider Business Practice Location Address
First Line	:	2711 TAMPA RD
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34684-3312
Country	:	US
Telephone Number	:	727-781-0491
Fax Number	:	727-937-8552

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

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	07/09/2007

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