Individual provider Active NPI

Victoria Flores-Carlson, CRNA

  • Certified Registered Nurse Anesthetist
  • Brandon, FL
National Provider Identifier
1104878263
Registry record updated Jan 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2844722 Issued in FL
Practice address
1706 Orange Hill Way
Brandon, FL 33510-2637
Phone
(813) 390-4628
NPI assigned
May 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 2844722 FL Primary

Addresses

Primary practice location

1706 Orange Hill Way
Brandon, FL 33510-2637

Mailing address

1706 Orange Hill Way
Brandon, FL 33510-2637
Phone (813) 390-4628

Other identifiers 4

IdentifierTypeStateIssuer
G3342OtherFLBCBS
G3342XOtherFLMEDICARE UPIN W/ FGTBA
G3342WOtherFLMEDICARE UPIN W/ GTBA
305723200MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100514000409 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 3173651916 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
2844722FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Aug 1, 2013 Accepting new patients
Tampa General Hospital Current Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC Current Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Aug 1, 2013 Accepting new patients
Florida Gulf-to-Bay Anesthesiology Associates, LLC Past Accepting new patients

Locations

24040 Tamiami Trl
Bonita Springs, FL 34134
Phone (239) 624-7153

15238 Virginia Sta
Odessa, FL 33556
Phone (813) 596-5200

6000 49th St N
St Petersburg, FL 33709
Phone (727) 521-4411

4016 Sun City Center Blvd
Sun City Ctr, FL 33573
Phone (813) 634-0145

2 Columbia Dr
Tampa, FL 33606
Phone (813) 844-7100

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

Interoperability endpoints

  • Direct secure messaging: vflorescarlson154373@direct.tgh.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327363200000",
    "number": "1104878263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 ORANGE HILL WAY",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335102637",
            "telephone_number": "813-390-4628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 ORANGE HILL WAY",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335102637",
            "telephone_number": "813-390-4628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORES-CARLSON",
        "first_name": "VICTORIA",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2012-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "2844722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "G3342",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE UPIN W/ FGTBA",
            "identifier": "G3342X",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE UPIN W/ GTBA",
            "identifier": "G3342W",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "305723200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.