Active NPI
Lady C Baez Pena, SA-C, P.A
- Surgical Assistant
- Orlando, FL
National Provider Identifier
1922790617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 24-279
- Practice address
- 3134 Landings Cir Apt 112
Orlando, FL 32824-0015 - Phone
- (850) 556-5073
- NPI assigned
- May 22, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1663-P.A. | PR | |
| Surgical Assistant | 246ZC0007X | 24-279 | FL | Primary |
Addresses
Primary practice location
3134 Landings Cir Apt 112
Orlando, FL 32824-0015
Mailing address
3134 Landings Cir Apt 112
Orlando, FL 32824-0015
Phone (850) 556-5073
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24-279 | FL | MD | Surgical Assistant |
| 1663-P.A. | PR | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715472000000",
"number": "1922790617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3134 LANDINGS CIR APT 112",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328240015",
"telephone_number": "850-556-5073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3134 LANDINGS CIR APT 112",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328240015",
"telephone_number": "850-556-5073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAEZ PENA",
"first_name": "LADY",
"middle_name": "C",
"credential": "SA-C, P.A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-22",
"last_updated": "2024-05-12",
"certification_date": "2024-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "PR",
"license": "1663-P.A.",
"primary": false
},
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "FL",
"license": "24-279",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.