MEDICARE: SUZANNE M OLIVER 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	ARNP1835842	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
2	G0887	OTHER	FL	BLUE SHIELD PROV #

General Provider Information

NPI Number	:	1851344113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE M OLIVER CRNA

Provider Business Mailing Address
First Line	:	P.O. BOX 550412
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33355-0000
Country	:	US
Telephone Number	:	954-838-2371
Fax Number	:

Provider Business Practice Location Address
First Line	:	4470 SHERIDAN STREET
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-0000
Country	:	US
Telephone Number	:	954-962-3210
Fax Number	:	954-577-8556

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

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	10/31/2012

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Directions to “ SUZANNE M OLIVER CRNA” Practice Location

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