Individual provider Active NPI

Adrian Moya Raimundo, CRNA

  • Certified Registered Nurse Anesthetist
  • Maitland, FL
National Provider Identifier
1861098071
Registry record updated Feb 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN11009512 Issued in FL
Practice address
500 Winderley PL Ste 115
Maitland, FL 32751-7406
Phone
(786) 359-9359
NPI assigned
Dec 11, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2021

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 11009512 FL
Certified Registered Nurse Anesthetist 367500000X APRN11009512 FL Primary

Addresses

Primary practice location

500 Winderley PL Ste 115
Maitland, FL 32751-7406

Mailing address

500 Winderley PL Ste 115
Maitland, FL 32751-7406
Phone (786) 359-9359

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL ORLANDO

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
11009512FLMDCertified Registered Nurse Anesthetist
APRN11009512FLMDCertified Registered Nurse Anesthetist

NPI Registry JSON

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

{
    "created_epoch": "1607644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1861098071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 WINDERLEY PL STE 115",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517406",
            "telephone_number": "786-359-9359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 WINDERLEY PL STE 115",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517406",
            "telephone_number": "786-359-9359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYA RAIMUNDO",
        "first_name": "ADRIAN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-11",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "11009512",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11009512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ORLANDO",
            "affiliation": "N",
            "address_1": "52 W Underwood St",
            "city": "Orlando",
            "state": "FL",
            "country_code": "US",
            "postal_code": "328061110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Maitland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; 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.