Individual provider Active NPI

Danitza Lorena Canal Moreno, SA-C

  • Surgical Assistant
  • Orlando, FL
National Provider Identifier
1093466849
Registry record updated Jan 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
License
21-178 Issued in WI
Practice address
14313 Avalon Reserve Blvd Apt 304
Orlando, FL 32828-5139
Phone
(786) 508-3865
NPI assigned
Jan 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X 21-178 WI Primary

Addresses

Primary practice location

14313 Avalon Reserve Blvd Apt 304
Orlando, FL 32828-5139

Mailing address

14313 Avalon Reserve Blvd Apt 304
Orlando, FL 32828-5139
Phone (786) 508-3865

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
21-178WIMDSurgical Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1642032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1093466849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14313 AVALON RESERVE BLVD APT 304",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328285139",
            "telephone_number": "786-508-3865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14313 AVALON RESERVE BLVD APT 304",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328285139",
            "telephone_number": "786-508-3865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANAL MORENO",
        "first_name": "DANITZA",
        "middle_name": "LORENA",
        "credential": "SA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-13",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "WI",
            "license": "21-178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.