Healthcare Provider Details

I. General information

NPI: 1174070973
Provider Name (Legal Business Name): JOSUE SARMIENTO ALVAREZ CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2016
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 W MILLER ST
ORLANDO FL
32806-2032
US

IV. Provider business mailing address

92 W MILLER ST
ORLANDO FL
32806-2032
US

V. Phone/Fax

Practice location:
  • Phone: 218-414-6073
  • Fax: 321-841-4603
Mailing address:
  • Phone: 218-414-6073
  • Fax: 321-841-4603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number110099
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP9445275
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: