Provider Demographics
NPI:1841207552
Name:BAYTAN, ANNA-MARIE R (CRBA)
Entity Type:Individual
Prefix:
First Name:ANNA-MARIE
Middle Name:R
Last Name:BAYTAN
Suffix:
Gender:F
Credentials:CRBA
Other - Prefix:
Other - First Name:ANN MARIE
Other - Middle Name:
Other - Last Name:PROM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 551420
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33355-1420
Mailing Address - Country:US
Mailing Address - Phone:800-243-3839
Mailing Address - Fax:855-851-4405
Practice Address - Street 1:2727 W. DR. MLK JR BLVD
Practice Address - Street 2:#310
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607
Practice Address - Country:US
Practice Address - Phone:813-350-7244
Practice Address - Fax:813-350-7246
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2747102367500000X
FLARNP2747102367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG3102ZMedicare PIN