Provider Demographics
NPI:1457318727
Name:MCCARTHY, CHAY (CRNA)
Entity Type:Individual
Prefix:
First Name:CHAY
Middle Name:
Last Name:MCCARTHY
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 1:2240 E BAY ISLE DR SE
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-3317
Mailing Address - Country:US
Mailing Address - Phone:727-823-0614
Mailing Address - Fax:727-550-0148
Practice Address - Street 1:2240 E BAY ISLE DR SE
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-3317
Practice Address - Country:US
Practice Address - Phone:727-823-0614
Practice Address - Fax:727-550-0148
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP622892367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG1577OtherBCBS
FL309036100Medicaid
FLG1577OtherBCBS