Provider Demographics
NPI:1215209135
Name:ERBEZNIK, ANA ROSE (CRNA)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:ROSE
Last Name:ERBEZNIK
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 1:15245 CHILLICOTHE RD
Mailing Address - Street 2:P.O. BOX 231
Mailing Address - City:NOVELTY
Mailing Address - State:OH
Mailing Address - Zip Code:44072-9656
Mailing Address - Country:US
Mailing Address - Phone:440-796-6832
Mailing Address - Fax:
Practice Address - Street 1:7111 FAIRWAY DRIVE, SUITE 450
Practice Address - Street 2:PALM BEACH GARDENS TEAM ANESTHESIA, PA
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418
Practice Address - Country:US
Practice Address - Phone:561-799-3552
Practice Address - Fax:561-799-3527
Is Sole Proprietor?:No
Enumeration Date:2012-02-08
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9335793367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered