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Individual

MR. MICHAEL J CERANOWSKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C, CAA

Contact information

Practice address
1775 W HIBISCUS BLVD STE 215, MELBOURNE, FL 32901-2627
(321) 837-3820
Mailing address
632 HAWKSBILL ISLAND DR, SATELLITE BEACH, FL 32937-3853
(228) 243-2210

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA03532 (INACTIVE)
TX
363AM0700X
Medical Physician Assistant
PA9104159
FL
367H00000X
Anesthesiologist Assistant
Primary
AA918
FL

Other

Enumeration date
10/02/2006
Last updated
02/09/2024
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