Individual provider Active NPI

Alex Larios Salinas

  • Surgical Physician Assistant
  • Lakeland, FL
National Provider Identifier
1487244513
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA9117490 Issued in FL
Practice address
5050 S Florida Ave
Lakeland, FL 33813-2501
Phone
(863) 688-3030
NPI assigned
Jan 22, 2021
Last updated
Jul 24, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA9117490 FL Primary

Addresses

Primary practice location

5050 S Florida Ave
Lakeland, FL 33813-2501

Mailing address

3730 Cat Mint St
Tampa, FL 33619-6937
Phone (941) 661-6445

Other practice location 1

3730 Cat Mint St
Tampa, FL 33619-6937
Phone (941) 661-6445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230629004257 FL Practitioner - Physician Assistant 1153780721 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9117490FLMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Chukwuka C Okafor, MD, Mba, PA CurrentSince Jun 8, 2023 Accepting new patients
Ospine, LLC PastSince Mar 21, 2021 Accepting new patients

Locations

5050 S Florida Ave
Lakeland, FL 33813
Phone (863) 644-1313

Organizations & group practices 2

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": "1611273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1487244513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3730 CAT MINT ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336196937",
            "telephone_number": "941-661-6445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 S FLORIDA AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132501",
            "telephone_number": "863-688-3030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3730 Cat Mint St",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336196937",
            "country_code": "US",
            "telephone_number": "941-661-6445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SALINAS",
        "first_name": "ALEX",
        "middle_name": "LARIOS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-22",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9117490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.