Provider Demographics
NPI:1598754855
Name:ROHWEDDER, CARL WALTER (CRNA)
Entity Type:Individual
Prefix:
First Name:CARL
Middle Name:WALTER
Last Name:ROHWEDDER
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:CARL
Other - Middle Name:WALTER
Other - Last Name:ALVAREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:510 LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:EUSTIS
Mailing Address - State:FL
Mailing Address - Zip Code:32726-4027
Mailing Address - Country:US
Mailing Address - Phone:352-357-8881
Mailing Address - Fax:352-357-8881
Practice Address - Street 1:510 LAKESHORE DR
Practice Address - Street 2:
Practice Address - City:EUSTIS
Practice Address - State:FL
Practice Address - Zip Code:32726-4027
Practice Address - Country:US
Practice Address - Phone:352-357-8881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3244542367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU1331AMedicare ID - Type Unspecified