Provider Demographics
NPI:1154698835
Name:RAPOSO, LISA RAVEN (CRNA)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:RAVEN
Last Name:RAPOSO
Suffix:
Gender:F
Credentials:CRNA
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Mailing Address - Street 1:5151 COLLINS AVE APT 1121
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2716
Mailing Address - Country:US
Mailing Address - Phone:305-397-8780
Mailing Address - Fax:
Practice Address - Street 1:5151 COLLINS AVE APT 1121
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2716
Practice Address - Country:US
Practice Address - Phone:305-397-8780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-22
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP9288457367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered