MEDICARE: PAULA SCHULAK 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	ARNP708312	FL

General Provider Information

NPI Number	:	1902864267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAULA SCHULAK CRNA

Provider Business Mailing Address
First Line	:	4519 GEORGE RD
Second Line	:	STE 100
City	:	TAMPA
State	:	FL
Zip	:	33634-7329
Country	:	US
Telephone Number	:	813-496-1075
Fax Number	:	813-249-7762

Provider Business Practice Location Address
First Line	:	3615 W SAN PEDRO ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33629-6925
Country	:	US
Telephone Number	:	813-625-1470
Fax Number	:	813-249-7762

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

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	07/08/2007

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