Individual provider Active NPI

Boris Rodriguez Fernandez, CRNA

  • Certified Registered Nurse Anesthetist
  • Miami, FL
National Provider Identifier
1306003413
Registry record updated May 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN9361023 Issued in FL
Practice address
17567 S Dixie Hwy
Miami, FL 33157-5435
Phone
(786) 293-9544
Fax
(786) 293-9594
NPI assigned
May 19, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2019

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 APRN9361023 FL Primary

Addresses

Primary practice location

17567 S Dixie Hwy
Miami, FL 33157-5435

Mailing address

11031 NE 6TH Ave
Miami, FL 33161-7182
Phone (305) 398-6100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180423001595 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 3173886363

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN9361023FLMDCertified Registered Nurse Anesthetist

NPI Registry JSON

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558656000000",
    "number": "1306003413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11031 NE 6TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331617182",
            "telephone_number": "305-398-6100",
            "fax_number": "305-757-4465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17567 S DIXIE HWY",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331575435",
            "telephone_number": "786-293-9544",
            "fax_number": "786-293-9594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ FERNANDEZ",
        "first_name": "BORIS",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-19",
        "last_updated": "2019-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN9361023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2019; 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.