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NPI Code Detail

MEDICARE: YESENIA DEJESUS-SUAREZ CRNA

MEDICARE:   YESENIA  DEJESUS-SUAREZ  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 AnesthetistARNP9249741FL

General Provider Information

NPI Number : 1558434852
Entity Type Code : Individual
Provider Name (Legal Business Name) : YESENIA DEJESUS-SUAREZ CRNA
Provider Business Mailing Address
First Line : 205 DINNER LAKE LOOP
Second Line :
City : LAKE WALES
State : FL
Zip : 33859-2153
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 205 DINNER LAKE LOOP
Second Line :
City : LAKE WALES
State : FL
Zip : 33859-2153
Country : US
Telephone Number : 787-914-5315
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2006
Last Update Date : 07/08/2007

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Directions to “ YESENIA DEJESUS-SUAREZ CRNA” Practice Location

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