Angela Marie Bacon, CRNA | |
11375 Cortez Blvd, Brooksville, FL 34613-5409 | |
(352) 596-6632 | |
Not Available |
Full Name | Angela Marie Bacon |
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Gender | Female |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 11375 Cortez Blvd, Brooksville, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1235873449 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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367500000X | Nurse Anesthetist, Certified Registered | 139305 (Florida) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | RN593231 (Pennsylvania) | Primary |
Entity Name | Sunshine State Anesthesia Partners Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1437757127 PECOS PAC ID: 8123434792 Enrollment ID: O20210305000003 |
Mailing Address | Practice Location Address |
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Angela Marie Bacon, CRNA 3205 Grand Ave Apt 408, Pinellas Park, FL 33782-6145 Ph: (412) 908-3972 | Angela Marie Bacon, CRNA 11375 Cortez Blvd, Brooksville, FL 34613-5409 Ph: (352) 596-6632 |
Nicole Marie Dibella, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 11375 Cortez Blvd, Brooksville, FL 34613 Phone: 352-596-6632 | |
Gail Shue, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 15205 Cortez Blvd, Brooksville, FL 34613 Phone: 352-597-7744 Fax: 352-597-7797 | |
Arnold Szabo, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 11375 Cortez Blvd, Brooksville, FL 34613 Phone: 352-596-6632 | |
Rodney Holcomb, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 11375 Cortez Blvd, Brooksville, FL 34613 Phone: 352-544-7112 Fax: 352-688-7224 | |
Mrs. Lorna Marie Gonzalez, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 11375 Cortez Blvd, Brooksville, FL 34613 Phone: 352-596-6632 Fax: 352-688-7224 | |
Scott Lamar Babcock, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 15205 Cortez Blvd, Brooksville, FL 34613 Phone: 352-597-7744 Fax: 352-597-7797 |