Provider Demographics
NPI:1396722419
Name:BALDINI, BARRY (CRNA)
Entity type:Individual
Prefix:
First Name:BARRY
Middle Name:
Last Name:BALDINI
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 MEDALIST WAY
Mailing Address - Street 2:
Mailing Address - City:ROTONDA WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33947-2174
Mailing Address - Country:US
Mailing Address - Phone:941-698-1983
Mailing Address - Fax:
Practice Address - Street 1:3333 CATTLEMEN RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232-6056
Practice Address - Country:US
Practice Address - Phone:941-379-5884
Practice Address - Fax:844-876-0873
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRNA18640367500000X
FL031148367500000X
FLARNP9247867367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI007001880Medicare ID - Type Unspecified