Provider Demographics
NPI:1871927244
Name:BARTLETT, RANDI (CRNA)
Entity type:Individual
Prefix:
First Name:RANDI
Middle Name:
Last Name:BARTLETT
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7154 N UNIVERSITY DR # 316
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2916
Mailing Address - Country:US
Mailing Address - Phone:954-720-3188
Mailing Address - Fax:954-586-2589
Practice Address - Street 1:4485 N STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33319-5876
Practice Address - Country:US
Practice Address - Phone:954-720-3188
Practice Address - Fax:954-586-2589
Is Sole Proprietor?:No
Enumeration Date:2013-08-21
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209010614367500000X
FLAPRN9410034367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered