Individual
MS. MARJORIE BURRY MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4204 W WOODMERE RD, TAMPA, FL 33609-3842
(813) 600-7395
Mailing address
4204 W WOODMERE RD, TAMPA, FL 33609-3842
(813) 600-7395
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9243538
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038633000
—
FL
01
—
G4317
BCBS
FL
Enumeration date
09/06/2005
Last updated
07/19/2012
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