Individual
CAROL M WIRTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
115 CRESCENT DR, FORT MYERS, FL 33919-6101
(239) 281-6722
(239) 433-9569
Mailing address
115 CRESCENT DR, FORT MYERS, FL 33919-6101
(239) 281-6722
(239) 433-9569
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
209004737
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP3133532
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
304460200
—
FL
01
—
G2100
BCBS
—
Enumeration date
08/26/2005
Last updated
02/27/2017
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