Individual
MRS. JOHNNILYNN MASSUCCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
901 45TH ST, WEST PALM BEACH, FL 33407-2413
(561) 844-6300
Mailing address
3716 MCKINLEY ST, HOLLYWOOD, FL 33021-4943
(954) 391-7624
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN3232392
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G00SD
BCBS
FL
Enumeration date
11/12/2010
Last updated
04/23/2013
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