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Individual

BURT H. PENA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
400 N MILLS AVE, ORLANDO, FL 32803-5722
(407) 872-2244
(407) 926-9173
Mailing address
PO BOX 4985, ORLANDO, FL 32802-4985
(407) 872-2244
(407) 926-9173

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9227988
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PENDING
FLORIDA BC/BS
FL
05
PENDING
FL
Enumeration date
06/23/2009
Last updated
08/07/2009
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