MEDICARE: ANITA LOUISE FIORLETTA 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	219885	TX

General Provider Information

NPI Number	:	1518991512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANITA LOUISE FIORLETTA CRNA

Provider Business Mailing Address
First Line	:	10003 BELL ROCK RD
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75035-9204
Country	:	US
Telephone Number	:	214-215-9581
Fax Number	:

Provider Business Practice Location Address
First Line	:	603 MATLOCK CENTRE CIRCLE
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76015-2535
Country	:	US
Telephone Number	:	817-701-1161
Fax Number	:	817-701-1164

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

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	06/20/2008

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