Medina, Marjorie Burry

Medina, Marjorie Burry is an sole proprietor health care provider with primary practice located at 4204 W Woodmere Rd , Tampa FL 33609-3842. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Medina, Marjorie Burry can be contacted via phone (813) 600-7395.

Contact Information

Primary practice address
4204 W Woodmere Rd Tampa FL 33609-3842
Phone: (813) 600-7395
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X ARNP9243538 Florida

Profile Details

NPI number 1316931322
LBN Legal business name Medina, Marjorie Burry
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 6th, 2005
Last updated Jul 19th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316931322 NPPES
Florida MEDICAID 038633000
Florida Other G4317

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