Individual
JEANNE MARIE ANTOLCHICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
12502 USF PINE DRIVE, TAMPA, FL 33612-9499
(813) 975-7130
Mailing address
PO BOX 8500, LOCKBOX # 7642, PHILADELPHIA, PA 19178-7642
(813) 281-8115
(813) 281-8656
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
9202934
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000133200
—
FL
Enumeration date
06/12/2008
Last updated
04/10/2013
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