Individual
MS. ANDREA BAUER BANTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRN
Contact information
Practice address
1613 HARRISON PKWY, SUNRISE, FL 33323-2896
(180) 043-7267
Mailing address
11120 SW 58TH CT, PINECREST, FL 33156-5015
(305) 794-9016
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9222380
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9222380
FL
Other
Enumeration date
12/22/2010
Last updated
11/20/2019
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