Provider Demographics
NPI:1326599564
Name:IMPERIALE, STARLYN (CRNA)
Entity Type:Individual
Prefix:
First Name:STARLYN
Middle Name:
Last Name:IMPERIALE
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 1:813 OHIO AVE
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34683-4242
Mailing Address - Country:US
Mailing Address - Phone:850-324-0395
Mailing Address - Fax:
Practice Address - Street 1:3231 MCMULLEN BOOTH RD
Practice Address - Street 2:
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695
Practice Address - Country:US
Practice Address - Phone:727-210-8191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-24
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9310685163W00000X
FLARNP9310685367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse