Provider Demographics
NPI:1114023413
Name:ALSOBROOK, CAROL E (CRNA)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:E
Last Name:ALSOBROOK
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:
Other - Last Name:BALSIZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:38135 MARKET SQ
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-7505
Mailing Address - Country:US
Mailing Address - Phone:813-528-4975
Mailing Address - Fax:
Practice Address - Street 1:14547 BRUCE B DOWNS BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-2709
Practice Address - Country:US
Practice Address - Phone:813-978-1494
Practice Address - Fax:813-355-5044
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1686082367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP01653073OtherRR MEDICARE
FLG1864W - TPAMedicare PIN
FLG1864X - PASCOMedicare PIN