Provider Demographics
NPI:1366458176
Name:MARIN, JUDITH ANN (CRNA)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:ANN
Last Name:MARIN
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 1:4900 SW 46TH CT
Mailing Address - Street 2:APT 2004
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-6264
Mailing Address - Country:US
Mailing Address - Phone:281-236-3899
Mailing Address - Fax:
Practice Address - Street 1:3309 SW 34TH CIR
Practice Address - Street 2:STE 101
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-3392
Practice Address - Country:US
Practice Address - Phone:352-237-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9268755367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered