Individual provider Active NPI

Aitor Javier Roche Perez, SA-C

  • Surgical Assistant
  • Tampa, FL
National Provider Identifier
1790679546
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
License
25-282 Issued in FL
Practice address
2711 W Tampa Bay Blvd
Tampa, FL 33607-6815
Phone
(813) 416-1542
NPI assigned
Jun 5, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X 25-282 FL Primary

Addresses

Primary practice location

2711 W Tampa Bay Blvd
Tampa, FL 33607-6815

Mailing address

2711 W Tampa Bay Blvd
Tampa, FL 33607-6815
Phone (813) 416-1542

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
25-282FLMDSurgical Assistant

NPI Registry JSON

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

{
    "created_epoch": "1749081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1790679546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2711 W TAMPA BAY BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076815",
            "telephone_number": "813-416-1542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2711 W TAMPA BAY BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076815",
            "telephone_number": "813-416-1542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCHE PEREZ",
        "first_name": "AITOR JAVIER",
        "credential": "SA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-05",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "FL",
            "license": "25-282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.