MEDICARE: ROGER KARL PAJUNEN 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	R1485459	MN
2	367500000X	Certified Registered Nurse Anesthetist	APRN11004272	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	:	1598858524
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROGER KARL PAJUNEN CRNA

Provider Business Mailing Address
First Line	:	510 SE 5TH AVE APT 202
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33301-2989
Country	:	US
Telephone Number	:	612-965-1994
Fax Number	:

Provider Business Practice Location Address
First Line	:	6401 N FEDERAL HWY
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-1427
Country	:	US
Telephone Number	:	954-485-5666
Fax Number	:	954-484-1651

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

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	02/14/2020

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