Provider Demographics
NPI:1154415420
Name:WEISER, SETH (CRNA)
Entity type:Individual
Prefix:
First Name:SETH
Middle Name:
Last Name:WEISER
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 1:3854 TORREY PINES BLVD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34238-2831
Mailing Address - Country:US
Mailing Address - Phone:941-724-7384
Mailing Address - Fax:941-343-3967
Practice Address - Street 1:3854 TORREY PINES BLVD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34238-2831
Practice Address - Country:US
Practice Address - Phone:941-724-7384
Practice Address - Fax:941-343-3967
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1380852367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG0951OtherBLUE CROSS BLUE SHIELD
FL304954000Medicaid
FLP00029315OtherRAILROAD MEDICARE
FL304954000Medicaid