Provider Demographics
NPI:1447382718
Name:GULASI, ANDREA (CRNA)
Entity Type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:
Last Name:GULASI
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 1:1510 LAFAYETTE STREET
Mailing Address - Street 2:#D
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904
Mailing Address - Country:US
Mailing Address - Phone:304-224-9040
Mailing Address - Fax:
Practice Address - Street 1:2721 DEL PRADO BLVD
Practice Address - Street 2:CAPE CORAL SURGERY CENTER SUITE 100
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904
Practice Address - Country:US
Practice Address - Phone:239-242-8010
Practice Address - Fax:239-242-8020
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2407240367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
G2032ZMedicare ID - Type Unspecified