MR. MICHAEL J CERANOWSKI


Address: 4164 West County Highway 30a, Santa Rosa Beach, FL 32459
Phone: 8506222313

MR. MICHAEL J CERANOWSKI (NPI# 1033202775) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1033202775
Entity Type Individual
Full Name MR. MICHAEL J CERANOWSKI
Credential PA-C
Practice Address 4164 West County Highway 30a
Santa Rosa Beach
FL 32459
Practice Telephone 8506222313
Practice Fax Number 8506222718
Mailing Telephone 8506222313
Mailing Fax Number 8506222718
Enumeration Date 2006-10-02
Last Update Date 2015-04-03
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
PA9104159 FL Physician Assistants & Advanced Practice Nursing Providers
N 363AM0700X Physician Assistant
Specialization: Medical
PA03532 (INACTIV TX Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 4164 WEST COUNTY HIGHWAY 30A
City SANTA ROSA BEACH
State FL
Zip Code 32459

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1942797287 Lauren Mank Assistant Behavior Analyst 67 Hiker St Fl 32459, Santa Rosa Beach, FL 32459 2018-04-20
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1215485230 Tamra Snook Social Worker 156 N County Highway 393 Unit 1, Santa Rosa Beach, FL 32459 2016-09-19
1437605730 Alexandra Armstrong Physical Therapist 249 Mack Bayou Loop Ste 101, Santa Rosa Beach, FL 32459 2016-08-28
1386097749 Itetra Smith Behavior Technician 67 Hiker St, Santa Rosa Beach, FL 32459 2016-07-20
1730527086 Emerald Coast Medical Supplies LLC Portable X-ray and/or Other Portable Diagnostic Imaging Supplier 48 Bald Eagle Drive, Santa Rosa Beach, FL 32459 2013-06-10
1114269768 Pamela Jean Skaff Dentist 101 Lecom Way, Defuniak Springs, FL 32459 2013-03-21
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Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
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Competitor

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City SANTA ROSA BEACH
Zip Code 32459

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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