Provider Demographics
NPI:1114994126
Name:TRAMAZZO, VICTORIA M (CRNA)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:M
Last Name:TRAMAZZO
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:M
Other - Last Name:KLASH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:3601 W COMMERCIAL BLVD STE 4 AND 5
Mailing Address - Street 2:ANESCO NORTH BROWARD LLC
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3320
Mailing Address - Country:US
Mailing Address - Phone:954-485-5666
Mailing Address - Fax:954-484-1651
Practice Address - Street 1:6401 NORTH FEDERAL HIGHWAY
Practice Address - Street 2:IMPERIAL POINT MED CENTER
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308
Practice Address - Country:US
Practice Address - Phone:954-776-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3155752367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL306348800Medicaid
FL306348800Medicaid