Keith Latasiewicz, DNP-CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

APRN11005942 Issued in FL

Practice address

4500 San Pablo Rd S
Jacksonville, FL 32224-1865

Phone

(190) 495-3200

NPI assigned

Jan 23, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Keith Latasiewicz Professional name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anesthesia Physician Solutions of North Florida LLCGroup PAC ID 5597066001, 280 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida Fort Walton-Destin Hospital Hospital, Fort Walton Beach, FL, CCN 100223

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Anesthesia Physician Solutions of North Florida, LLC

  • Anesthesiology Physician
  • Gainesville, FL
  • NPI 1164932901

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Sheridan Healthcorp Inc

  • Anesthesiology Physician
  • Okeechobee, FL
  • NPI 1629781711

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• US Anesthesia Partners of Florida Inc.

  • Anesthesiology Physician
  • Maitland, FL
  • NPI 1518910520

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Anesthesia Physician Solutions of North Florida, LLC

  • Anesthesiology Physician
  • Fort Walton Beach, FL
  • NPI 1013423896
  NPD
• Anesthesia Physician Solutions of North Florida, LLC

  • Anesthesiology Physician
  • Kissimmee, FL
  • NPI 1902478431
  NPD
• Sheridan Healthcorp Inc

  • Anesthesiology Physician
  • Ft Lauderdale, FL
  • NPI 1821071960

  Nurse Anesthetist, Certified Registered

  NPD
• Sheridan Healthcorp, Inc.

  • Anesthesiology Physician
  • North Miami Beach, FL
  • NPI 1578429460
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fort Walton Beach Medical Center, Inc.

  • General Acute Care Hospital
  • Ft Walton Beach, FL
  • NPI 1639128820
  Care Compare affiliation

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

{
    "created_epoch": "1579737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1639709173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241865",
            "telephone_number": "904-953-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241865",
            "telephone_number": "190-495-3200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Health Park Blvd",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320865784",
            "country_code": "US",
            "telephone_number": "904-819-5155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LATASIEWICZ",
        "first_name": "KEITH",
        "name_prefix": "Mr.",
        "credential": "DNP-CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-23",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11005942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "flaglerhospital.org",
            "affiliation": "N",
            "address_1": "400 Health Park Blvd",
            "city": "St Augustine",
            "state": "FL",
            "country_code": "US",
            "postal_code": "320865784",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KEITH",
            "last_name": "LATASIEWICZ",
            "prefix": "MR.",
            "credential": "ARNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Susan Lassiter
• Peyton Elizabeth Lassley, PT, DPT
• Lasting Impression Care, Inc.
• Emma Elizabeth Lasure, DPT
• Kristina M Laszczak, PT
• Azalfa Uzair Lateef
• Audra Elisabeth Latham, LMHC
• Christopher Wright Latham, DMD
• Kathleen Lathram
• Mark Lathrop, CRNA

• Certified Registered Nurse Anesthetist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Certified Registered Nurse Anesthetist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; 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.