Provider Demographics
NPI:1346573672
Name:MIEDES, ELEIDY (CRNA)
Entity Type:Individual
Prefix:
First Name:ELEIDY
Middle Name:
Last Name:MIEDES
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1613 HARRISON PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2896
Mailing Address - Country:US
Mailing Address - Phone:954-838-2371
Mailing Address - Fax:954-851-1758
Practice Address - Street 1:9370 SUNSET DR
Practice Address - Street 2:# A-250
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-5431
Practice Address - Country:US
Practice Address - Phone:305-595-4510
Practice Address - Fax:305-595-9465
Is Sole Proprietor?:No
Enumeration Date:2009-09-18
Last Update Date:2009-09-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP9200892367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered