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NPI Code Detail

MEDICARE: VANESSA RIVERA CRNA

MEDICARE: VANESSA RIVERA 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
1367500000XCertified Registered Nurse AnesthetistAPRN11007354FL
2367500000XCertified Registered Nurse Anesthetist131501FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1861014557
Entity Type Code : Individual
Provider Name (Legal Business Name) : VANESSA RIVERA CRNA
Provider Business Mailing Address
First Line : 12026 WESTMORELAND WAY
Second Line :
City : FORT MYERS
State : FL
Zip : 33913-8486
Country : US
Telephone Number : 239-204-7280
Fax Number :
Provider Business Practice Location Address
First Line : 9981 S HEALTHPARK DR
Second Line :
City : FORT MYERS
State : FL
Zip : 33908-3620
Country : US
Telephone Number : 239-343-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2020
Last Update Date : 07/02/2020

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Directions to “ VANESSA RIVERA CRNA” Practice Location

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