Individual provider Active NPI

Alan John De la Vina, NP

  • Nurse Practitioner
  • Oviedo, FL
National Provider Identifier
1699418483
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11028542 Issued in FL
Practice address
1109 Brielle CT
Oviedo, FL 32765-5404
Phone
(863) 669-3415
NPI assigned
Apr 19, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X RN9530854 FL
Nurse Practitioner 363L00000X APRN11028542 FL Primary

Addresses

Primary practice location

1109 Brielle CT
Oviedo, FL 32765-5404

Mailing address

1109 Brielle CT
Oviedo, FL 32765-5404

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
I20231107000154 FL Practitioner - Nurse Practitioner 3173970555 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Emergency Physicians Kang and Associates MD LLCGroup PAC ID 0143113878, 318 clinicians

Practice addresses (Care Compare)

601 E Altamonte Dr
Emergency Department
Altamonte Springs, FL 32701-4802
Phone (407) 303-2200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN9530854FLMDEmergency Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Emergency Physicians Kang and Associates MD LLC CurrentSince Oct 1, 2023 Accepting new patients
Revive Transitional Care and in Home Primary Medicine, LLC CurrentSince Apr 6, 2024 Accepting new patients
Delavina Servcies LLC Current Accepting new patients
Delavina Services LLC Nurse Practitioner CurrentSince Jun 1, 2025 Accepting new patients

Locations

601 E Altamonte Dr
Altamonte Springs, FL 32701
Phone (407) 303-2200

1909 E Highway 50
Clermont, FL 34711
Phone (352) 717-3800

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1650326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1699418483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 BRIELLE CT",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327655404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 BRIELLE CT",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327655404",
            "telephone_number": "863-669-3415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA VINA",
        "first_name": "ALAN",
        "middle_name": "JOHN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-19",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "FL",
            "license": "RN9530854",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11028542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oviedo, FL

Sources for this page

Verify at the official NPI Registry.