Individual
MISS GINA FASOLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1525 W CYPRESS CREEK ROAD, FORT LAUDERDALE, FL 33309
(201) 615-6601
Mailing address
10 NORTH ST, ELMWOOD PARK, NJ 07407-2246
(201) 615-6601
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
11007198
FL
367500000X
Certified Registered Nurse Anesthetist
647022
NY
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN11007198
FL
Other
Enumeration date
12/17/2018
Last updated
04/14/2026
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