Provider Demographics
NPI:1124014675
Name:AARONSON, STEPHANIE MARIE (CRNA)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MARIE
Last Name:AARONSON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 24TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33704-2817
Mailing Address - Country:US
Mailing Address - Phone:727-821-5292
Mailing Address - Fax:727-821-5292
Practice Address - Street 1:531 24TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33704-2817
Practice Address - Country:US
Practice Address - Phone:727-821-5292
Practice Address - Fax:727-821-5292
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 2515842367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL303597200Medicaid
FLE5281YMedicare PIN
FL303597200Medicaid