Individual
MRS. MALLIKA SELVARAJU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1336 CREEKSIDE BLVD., SUITE 1, NAPLES, FL 34108
(239) 261-1158
(239) 261-4232
Mailing address
1336 CREEKSIDE BLVD., SUITE 1, NAPLES, FL 34108
(239) 261-1158
(239) 261-4232
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP2163362
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
305380600
—
FL
01
—
G3242
BLUE CROSS BLUE SHIELD
FL
Enumeration date
05/03/2006
Last updated
11/21/2016
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