MEDICARE: DEBORAH SUE HEBERT DLUGOSE 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	R107004	MD
2	367500000X	Certified Registered Nurse Anesthetist	096722	NC
3	367500000X	Certified Registered Nurse Anesthetist	ARNP9178270	FL
4	367500000X	Certified Registered Nurse Anesthetist	ARNP 9178270	FL

General Provider Information

NPI Number	:	1457347031
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBORAH SUE HEBERT DLUGOSE CRNA

Provider Business Mailing Address
First Line	:	PO BOX 1975
Second Line	:
City	:	OLDSMAR
State	:	FL
Zip	:	34677-6975
Country	:	US
Telephone Number	:	727-409-0701
Fax Number	:	813-854-2122

Provider Business Practice Location Address
First Line	:	10 N GREENE ST
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21201-1524
Country	:	US
Telephone Number	:	410-605-7000
Fax Number	:

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

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	07/08/2007

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