MEDICARE: MRS. KARIANE TERESA CERATO 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	163W00000X	Registered Nurse	RN9186406	FL
2	367500000X	Certified Registered Nurse Anesthetist	ARNP9186406	FL

General Provider Information

NPI Number	:	1821392887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KARIANE TERESA CERATO CRNA

Provider Business Mailing Address
First Line	:	13719 LONGS LANDING RD W
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32225-5423
Country	:	US
Telephone Number	:	352-226-5981
Fax Number	:

Provider Business Practice Location Address
First Line	:	13719 LONGS LANDING RD W
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32225-5423
Country	:	US
Telephone Number	:	352-226-5981
Fax Number	:

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

Provider Enumeration Date	:	01/05/2011
Last Update Date	:	11/12/2014

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