Individual
AMANDA DEWBERRY LASCANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 265-0077
Mailing address
PO BOX 13833, PHILADELPHIA, PA 19101-3833
(352) 265-0077
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9280743
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010691200
—
FL
Enumeration date
02/14/2014
Last updated
02/04/2016
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