Provider Demographics
NPI:1992120182
Name:ADLY, ABDUR-RAHMAN SAYED (CRNA)
Entity type:Individual
Prefix:
First Name:ABDUR-RAHMAN
Middle Name:SAYED
Last Name:ADLY
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 1:3021 STATE ROAD 590
Mailing Address - Street 2:APT 527
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-2599
Mailing Address - Country:US
Mailing Address - Phone:803-466-5521
Mailing Address - Fax:
Practice Address - Street 1:3021 STATE ROAD 590
Practice Address - Street 2:APT 527
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33759-2599
Practice Address - Country:US
Practice Address - Phone:803-466-5521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-24
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC201618163W00000X
FLARNP9389635367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse