Healthcare Provider Details

I. General information

NPI: 1811278997
Provider Name (Legal Business Name): JOHN VINCENT BELTRAN CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2011
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12998 MALLORY CIR APARTMENT 106
ORLANDO FL
32828-3826
US

IV. Provider business mailing address

12998 MALLORY CICLE APT # 106
ORLANDO FL
32828
US

V. Phone/Fax

Practice location:
  • Phone: 407-443-6551
  • Fax:
Mailing address:
  • Phone: 407-443-6551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN9204386
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: