Healthcare Provider Details

I. General information

NPI: 1255816518
Provider Name (Legal Business Name): LESTER ALEXANDER PINEDA CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2018
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9320 US HIGHWAY 301 S
RIVERVIEW FL
33578-6300
US

IV. Provider business mailing address

9320 US HIGHWAY 301 S
RIVERVIEW FL
33578-6300
US

V. Phone/Fax

Practice location:
  • Phone: 305-336-2209
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9331048
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11001091
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: