Provider Demographics
NPI:1902901812
Name:HOWARD, MARIA CECILIA FLORESCA (CRNA)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:CECILIA FLORESCA
Last Name:HOWARD
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:CECILIA
Other - Last Name:FLORESCA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:16001 W 9 MILE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-4818
Mailing Address - Country:US
Mailing Address - Phone:248-849-5806
Mailing Address - Fax:248-849-5489
Practice Address - Street 1:16001 W 9 MILE RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-4818
Practice Address - Country:US
Practice Address - Phone:248-849-5806
Practice Address - Fax:248-849-5489
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704211360367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4862613Medicaid
MIP00307719Medicare ID - Type UnspecifiedRAILROAD MEDICARE