Provider Demographics
NPI:1063410058
Name:MARCHIANO, ANTHONY ELEUTERIO (CRNA)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:ELEUTERIO
Last Name:MARCHIANO
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6640 ANCHOR LOOP
Mailing Address - Street 2:APT 108
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34212-4433
Mailing Address - Country:US
Mailing Address - Phone:941-567-6926
Mailing Address - Fax:941-567-6926
Practice Address - Street 1:6640 ANCHOR LOOP
Practice Address - Street 2:APT 108
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34212-4434
Practice Address - Country:US
Practice Address - Phone:941-567-6926
Practice Address - Fax:941-567-6926
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-13
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1703582367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL311663800Medicaid
FLF2107OtherBCBS OF FL
FL311663800Medicaid