Provider Demographics
NPI:1538425897
Name:CAMPO, ROWENA L (CRNA)
Entity type:Individual
Prefix:
First Name:ROWENA
Middle Name:L
Last Name:CAMPO
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ROWENA
Other - Middle Name:L
Other - Last Name:BUGARIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 817737
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33081-1737
Mailing Address - Country:US
Mailing Address - Phone:800-437-2672
Mailing Address - Fax:954-851-1758
Practice Address - Street 1:8201 WEST BROWARD BOULEVARD
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-0000
Practice Address - Country:US
Practice Address - Phone:954-476-3911
Practice Address - Fax:954-452-2185
Is Sole Proprietor?:No
Enumeration Date:2012-04-11
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9220978367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered