Provider Demographics
NPI:1295368215
Name:ZAKRAJSEK, AMANDA RAE (APRN CRNA)
Entity type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:RAE
Last Name:ZAKRAJSEK
Suffix:
Gender:F
Credentials:APRN CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 QUAIL DOWN DR
Mailing Address - Street 2:
Mailing Address - City:DEBARY
Mailing Address - State:FL
Mailing Address - Zip Code:32713-4506
Mailing Address - Country:US
Mailing Address - Phone:440-547-6638
Mailing Address - Fax:
Practice Address - Street 1:92 W MILLER ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2036
Practice Address - Country:US
Practice Address - Phone:321-843-8851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-18
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH127963367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered