Individual provider Active NPI

Edwin Yanul Disla, CRNA

  • Certified Registered Nurse Anesthetist
  • Melbourne, FL
National Provider Identifier
1497098412
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN3089142 Issued in FL
Practice address
1350 Hickory St
Melbourne, FL 32901-3224
Phone
(321) 434-7000
NPI assigned
Mar 27, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN3089142 FL
Certified Registered Nurse Anesthetist 367500000X APRN3089142 FL Primary

Addresses

Primary practice location

1350 Hickory St
Melbourne, FL 32901-3224

Mailing address

11921 Nautica Dr
Orlando, FL 32827-7119
Phone (321) 278-8848

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130729001016 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 7012158397 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ophthalmology Anesthesia Services LLCGroup PAC ID 3870491038, 5 clinicians

Practice addresses (Care Compare)

105 Bonnie Loch CT
Orlando, FL 32806-2909
Phone (407) 428-0040

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN3089142FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Physician Solutions of North Florida, LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 20, 2016 Accepting new patients
Sheridan Healthcorp, Inc. Nurse Anesthetist, Certified Registered CurrentSince Aug 12, 2018 Accepting new patients
The Stingl Family Foundation, Inc CurrentSince May 7, 2016 Accepting new patients
Anesthesia Physician Solutions of North Florida, LLC CurrentSince Jun 20, 2016 Accepting new patients
Sheridan Healthcorp Inc Nurse Anesthetist, Certified Registered Current Accepting new patients
Anesthesia Physician Solutions of North Florida, LLC Nurse Anesthetist, Certified Registered Current Accepting new patients
Ams National LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 20, 2018 Accepting new patients
Ophthalmology Anesthesia Services LLC CurrentSince Oct 1, 2020 Accepting new patients
Sheridan Healthcorp, Inc. CurrentSince Aug 12, 2018 Accepting new patients

Locations

4500 Newberry Rd
Gainesville, FL 32607
Phone (352) 367-2310

301 Memorial Medical Pkwy
Holly Hill, FL 32117
Phone (386) 231-3906

700 W Oak St
Kissimmee, FL 34741
Phone (407) 518-3553

1304 Oak St
Melbourne, FL 32901
Phone (321) 345-4002

6002 Berryhill Rd
Milton, FL 32570
Phone (850) 474-8688

105 Bonnie Loch Ct
Orlando, FL 32806
Phone (407) 428-0040

8383 N Davis Hwy
Pensacola, FL 32514
Phone (850) 494-3212

325 Cypress Pkwy
Poinciana, FL 34759
Phone (407) 530-2000

1613 NW 136th Ave
Ste 200
Sunrise, FL 33323
Phone (954) 838-2502

6733 Gall Blvd
Zephyrhills, FL 33542
Phone (813) 783-8242

Organizations & group practices 9

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": "1364342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1497098412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11921 NAUTICA DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328277119",
            "telephone_number": "321-278-8848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 HICKORY ST",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329013224",
            "telephone_number": "321-434-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISLA",
        "first_name": "EDWIN",
        "middle_name": "YANUL",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-27",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "RN3089142",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN3089142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.