Individual provider Active NPI

Israel Soto Rolon, CRNA

  • Certified Registered Nurse Anesthetist
  • Wellington, FL
National Provider Identifier
1720095110
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
9196252 Issued in FL
Practice address
12230 W Forest Hill Blvd
Wellington, FL 33414-5700
Phone
(561) 798-4221
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 9196252 FL Primary

Addresses

Primary practice location

12230 W Forest Hill Blvd
Wellington, FL 33414-5700

Mailing address

804 Scott Nixon Memorial Dr
Augusta, GA 30907-2464

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040525000614 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 2961483144 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of Puerto Rico School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sheridan Healthcorp IncGroup PAC ID 3173429693, 956 clinicians

Practice addresses (Care Compare)

13001 Southern Blvd
Loxahatchee, FL 33470-9203
Phone (561) 798-3300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9196252FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Sheridan Healthcorp Inc Nurse Anesthetist, Certified Registered Current Accepting new patients
Sheridan Healthcorp Inc Nurse Anesthetist, Certified Registered CurrentSince Dec 27, 2017 Accepting new patients
Anesthesia Physician Solutions of South Florida, LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 27, 2017 Accepting new patients
Anesthesia Physician Solutions of South Florida, LLC Nurse Anesthetist, Certified Registered Current Accepting new patients
Anesthesia Physician Solutions of South Florida, LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 27, 2017 Accepting new patients
Anesthesiology Consultants of the Palm Beaches PA PastSince Jan 19, 2004 Accepting new patients

Locations

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

7201 N University Dr
Tamarac, FL 33321
Phone (954) 721-2200

13001 State Road 80
Westlake, FL 33470
Phone (561) 793-3300

Organizations & group practices 6

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720095110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SCOTT NIXON MEMORIAL DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309072464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12230 W FOREST HILL BLVD",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334145700",
            "telephone_number": "561-798-4221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOTO ROLON",
        "first_name": "ISRAEL",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "9196252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.