Provider Demographics
NPI:1437205531
Name:MILANI, LORENA SHANNON (CRNA)
Entity Type:Individual
Prefix:
First Name:LORENA
Middle Name:SHANNON
Last Name:MILANI
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 1:1009 CORONADO CT
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32563-3071
Mailing Address - Country:US
Mailing Address - Phone:850-624-9784
Mailing Address - Fax:
Practice Address - Street 1:801 E 6TH ST
Practice Address - Street 2:SUITE 205
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-3661
Practice Address - Country:US
Practice Address - Phone:850-785-3185
Practice Address - Fax:850-785-6233
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9230181367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG3894OtherFL BCBS
FLARNP9230181OtherFL LICENSE
FLG3894ZMedicare ID - Type UnspecifiedFL MEDICARE