Provider Demographics
NPI:1912949249
Name:NAWALANIC, JOHN E (CRNA, MS)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:E
Last Name:NAWALANIC
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Gender:M
Credentials:CRNA, MS
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Mailing Address - Street 1:2900 NE 23RD PL
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-1138
Mailing Address - Country:US
Mailing Address - Phone:954-788-5441
Mailing Address - Fax:954-788-2591
Practice Address - Street 1:2120 NW 107TH TER
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33322-3418
Practice Address - Country:US
Practice Address - Phone:954-741-0636
Practice Address - Fax:954-741-0639
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2010-09-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP 1837262367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL033633500Medicaid
FL033633500Medicaid