Basic Information
| Provider Information | |||||||||
| NPI: | 1770830168 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NOEL | ||||||||
| FirstName: | EVROSE | ||||||||
| MiddleName: | PHILIAS | ||||||||
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| Credential: | CRNA, MSN, MPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10291 SOUTHWEST 18TH STREET | ||||||||
| Address2: | |||||||||
| City: | MIRAMAR | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330251739 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3053332739 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3661 S MIAMI AVE | ||||||||
| Address2: | SUITE 504 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331334236 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3058540302 | ||||||||
| FaxNumber: | 3058540308 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/06/2012 | ||||||||
| LastUpdateDate: | 08/13/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | ARNP9231268 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.