MEDICARE: MRS. MARDI LYNN SCOTT 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	ARNP3400272	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G3588	OTHER	FL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568460301
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARDI LYNN SCOTT CRNA

Provider Business Mailing Address
First Line	:	1 TAMPA GENERAL CIR
Second Line	:	SUITE A327
City	:	TAMPA
State	:	FL
Zip	:	33606-3571
Country	:	US
Telephone Number	:	813-844-7677
Fax Number	:	813-844-7677

Provider Business Practice Location Address
First Line	:	1 TAMPA GENERAL CIR
Second Line	:	SUITE A327
City	:	TAMPA
State	:	FL
Zip	:	33606-3571
Country	:	US
Telephone Number	:	813-844-7677
Fax Number	:	813-844-7677

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

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	11/08/2012

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