MEDICARE: DR. JESSICA S OCANDO CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	APRN11026599	FL
2	163W00000X	Registered Nurse	RN9248649	FL

General Provider Information

NPI Number	:	1093395410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JESSICA S OCANDO CRNA

Provider Business Mailing Address
First Line	:	2211 NE 37TH CT
Second Line	:
City	:	LIGHTHOUSE POINT
State	:	FL
Zip	:	33064-3909
Country	:	US
Telephone Number	:	954-691-8619
Fax Number	:

Provider Business Practice Location Address
First Line	:	2211 NE 37TH CT
Second Line	:
City	:	LIGHTHOUSE POINT
State	:	FL
Zip	:	33064-3909
Country	:	US
Telephone Number	:	954-691-8619
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2021
Last Update Date	:	02/05/2026

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