Individual provider Active NPI

Alejandro Andre Pabon Rodriguez, CRNA

  • Certified Registered Nurse Anesthetist
  • Daytona Beach, FL
National Provider Identifier
1205356946
Registry record updated Nov 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
9486512 Issued in FL
Practice address
Florida Hospital Memorial Medical Center
301 Memorial Medical Parkway
Daytona Beach, FL 32117
Phone
(787) 244-9411
Fax
(386) 231-5962
NPI assigned
Jun 23, 2017
Last updated
Nov 5, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2018

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 9486512 FL Primary

Addresses

Primary practice location

Florida Hospital Memorial Medical Center
301 Memorial Medical Parkway
Daytona Beach, FL 32117

Mailing address

Florida Hospital Memorial Medical Center
301 Memorial Medical Parkway
Daytona Beach, FL 32117
Phone (787) 244-9411

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181113002931 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 9335493188 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9486512FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Mary Surgery Center LLC Current Accepting new patients
Anesthesiologists of Greater Orlando Inc Nurse Anesthetist, Certified Registered CurrentSince Sep 17, 2018 Accepting new patients
East Coast Anesthesia LLC CurrentSince Aug 1, 2020 Accepting new patients
Anesthesiology Professional Services, Inc. CurrentSince May 8, 2020 Accepting new patients
Orange City Anesthesia Services LLC CurrentSince Jul 23, 2019 Accepting new patients
Anesthesiologists of Greater Orlando Inc Nurse Anesthetist, Certified Registered CurrentSince Sep 17, 2018 Accepting new patients

Locations

2234 N Federal Hwy
Boca Raton, FL 33431
Phone (561) 306-5469

401 SW 42nd Ave
Ste 201
Coral Gables, FL 33134
Phone (305) 447-0882

460 Saint Charles Ct
Lake Mary, FL 32746
Phone (407) 585-0260

555 W State Road 434
Longwood, FL 32750
Phone (407) 767-1200

975 Town Center Dr
Ste 100
Orange City, FL 32763
Phone (386) 456-5247

1405 S Orange Ave
Ste 400
Orlando, FL 32806
Phone (407) 426-8331

45 W Crystal Lake St
Ste 300
Orlando, FL 32806
Phone (407) 254-2526

83 W Miller St
Orlando, FL 32806
Phone (321) 841-5281

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1498176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541376000000",
    "number": "1205356946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FLORIDA HOSPITAL MEMORIAL MEDICAL CENTER",
            "address_2": "301 MEMORIAL MEDICAL PARKWAY",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "32117",
            "telephone_number": "787-244-9411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FLORIDA HOSPITAL MEMORIAL MEDICAL CENTER",
            "address_2": "301 MEMORIAL MEDICAL PARKWAY",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "32117",
            "telephone_number": "787-244-9411",
            "fax_number": "386-231-5962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PABON RODRIGUEZ",
        "first_name": "ALEJANDRO",
        "middle_name": "ANDRE",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-23",
        "last_updated": "2018-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "9486512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2018; 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.