MEDICARE: JOANN TOMICH 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	171W00000X	Contractor	ARNP890032	FL
2	367500000X	Certified Registered Nurse Anesthetist	ARNP890032	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1326094525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANN TOMICH CRNA

Provider Business Mailing Address
First Line	:	1756 SW CAPTAINS PL
Second Line	:
City	:	PALM CITY
State	:	FL
Zip	:	34990-1746
Country	:	US
Telephone Number	:	772-283-8588
Fax Number	:

Provider Business Practice Location Address
First Line	:	1756 SW CAPTAINS PL
Second Line	:
City	:	PALM CITY
State	:	FL
Zip	:	34990-1746
Country	:	US
Telephone Number	:	772-283-8588
Fax Number	:	772-283-8588

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

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	09/23/2010

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