Provider Demographics
NPI:1346878873
Name:CARDENAS, OSCAR A (RN, BSN, CCRN)
Entity Type:Individual
Prefix:
First Name:OSCAR
Middle Name:A
Last Name:CARDENAS
Suffix:
Gender:M
Credentials:RN, BSN, CCRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 SW GLENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34984-5025
Mailing Address - Country:US
Mailing Address - Phone:239-682-3042
Mailing Address - Fax:
Practice Address - Street 1:178 SW GLENWOOD DR
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34984-5025
Practice Address - Country:US
Practice Address - Phone:239-682-3042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-30
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9367866390200000X
FLAPRN11019697367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program