Provider Demographics
NPI:1578663670
Name:AIRALA, SUSANA M (CRNA)
Entity Type:Individual
Prefix:
First Name:SUSANA
Middle Name:M
Last Name:AIRALA
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 1:7600 SW 87TH AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3601
Mailing Address - Country:US
Mailing Address - Phone:305-595-2414
Mailing Address - Fax:
Practice Address - Street 1:7600 SW 87TH AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3601
Practice Address - Country:US
Practice Address - Phone:305-595-2414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLANT9191655367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered