Individual provider Active NPI

Richard Lazaro Luis, CRNA, DNP

  • Certified Registered Nurse Anesthetist
  • Miami, FL
National Provider Identifier
1447764733
Registry record updated Nov 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN9328625 Issued in FL
Practice address
1400 NW 12TH Ave
Miami, FL 33136-1003
Phone
(305) 325-5511
NPI assigned
Nov 22, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2017

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 RN9328625 FL Primary

Addresses

Primary practice location

1400 NW 12TH Ave
Miami, FL 33136-1003

Mailing address

8600 SW 128TH St
Miami, FL 33156-5826

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180806002170 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4385992445 Reassigns benefits to 2 organizations
I20240516002669 CA Practitioner - Certified Registered Nurse Anesthetist (Crna) 4385992445 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN9328625FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia on Demand - a Professional Nursing Corporation Nurse Anesthetist, Certified Registered CurrentSince Apr 15, 2024 Accepting new patients
East Coast Anesthesia LLC CurrentSince Mar 15, 2020 Accepting new patients
Anesthesiology Professional Services, Inc. CurrentSince May 14, 2020 Accepting new patients

Locations

801 S Chevy Chase Dr
Ste 106
Glendale, CA 91205
Phone (818) 265-2275

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

6100 Waterford District Dr
Ste 450
Miami, FL 33126

Organizations & group practices 3

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": "1511308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511308800000",
    "number": "1447764733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8600 SW 128TH ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331565826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361003",
            "telephone_number": "305-325-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUIS",
        "first_name": "RICHARD",
        "middle_name": "LAZARO",
        "name_prefix": "Dr.",
        "credential": "CRNA, DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-22",
        "last_updated": "2017-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "RN9328625",
            "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 Nov 22, 2017; 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.