Provider Demographics
NPI:1952356271
Name:OTTATI, FRANK ROBERT (CRNA)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:ROBERT
Last Name:OTTATI
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 1:932 SOUTHERN OAK LN
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-2905
Mailing Address - Country:US
Mailing Address - Phone:407-616-5833
Mailing Address - Fax:
Practice Address - Street 1:1817 N MILLS AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1853
Practice Address - Country:US
Practice Address - Phone:407-896-1726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3194762367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL305629500Medicaid
FLG3320OtherBCBS
FLG3320ZMedicare ID - Type Unspecified