Organization
LINDA M. ROSS PEDERSEN, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LINDA M ROSS PEDERSEN CRNA (PRESIDENT)
(239) 357-8256
Entity
Organization
Contact information
Practice address
3700 CENTRAL AVE, SUITE 2, FORT MYERS, FL 33901-7649
(239) 275-0665
(239) 275-0503
Mailing address
1039 SAND CASTLE RD, SANIBEL, FL 33957-3614
(239) 357-8256
(239) 395-3375
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP1927642
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
304513700
—
FL
01
—
430051711
RAILROAD MEDICARE
—
01
—
G0375
BC/BS FL
FL
Enumeration date
11/21/2012
Last updated
06/20/2018
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