Provider Demographics
NPI:1316913320
Name:BECKER, REBECCA (CRNA)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:BECKER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:CANTOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3601 W COMMERCIAL BLVD
Mailing Address - Street 2:C/O ANESCO NORTH BROWARD LLC
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3300
Mailing Address - Country:US
Mailing Address - Phone:954-485-5666
Mailing Address - Fax:957-484-1651
Practice Address - Street 1:3000 CORAL SPRINGS DR
Practice Address - Street 2:C/O CORAL SPRINGS MEDICAL CENTER
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-3873
Practice Address - Country:US
Practice Address - Phone:954-344-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1797752367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL034796500Medicaid
FLG1592YMedicare ID - Type Unspecified