Healthcare Provider Details

I. General information

NPI: 1114886132
Provider Name (Legal Business Name): JAVIER RODRIGUEZ DE LA FLOR CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10021 SW 35TH TER
MIAMI FL
33165-3832
US

IV. Provider business mailing address

10021 SW 35TH TER
MIAMI FL
33165-3832
US

V. Phone/Fax

Practice location:
  • Phone: 786-208-7010
  • Fax: 786-208-7010
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN9401251
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number11044609
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: