MEDICARE: JOSHUA BEMPAH 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	RN291181	GA
2	367500000X	Certified Registered Nurse Anesthetist	006867	NC
3	367500000X	Certified Registered Nurse Anesthetist	1084058	TX

General Provider Information

NPI Number	:	1861011082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSHUA BEMPAH CRNA

Provider Business Mailing Address
First Line	:	104 FOREST CIR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32803-6248
Country	:	US
Telephone Number	:	704-692-3852
Fax Number	:

Provider Business Practice Location Address
First Line	:	104 FOREST CIR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32803-6248
Country	:	US
Telephone Number	:	704-692-3852
Fax Number	:

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

Provider Enumeration Date	:	04/09/2020
Last Update Date	:	03/21/2023

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