Provider Demographics
NPI:1376564054
Name:KNIGHT, ALEJANDRO (CRNA)
Entity Type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1329 SW 16TH ST RM 2232
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-1128
Mailing Address - Country:US
Mailing Address - Phone:352-733-0485
Mailing Address - Fax:
Practice Address - Street 1:1690 DUNLAWTON AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32127-8979
Practice Address - Country:US
Practice Address - Phone:386-481-6674
Practice Address - Fax:386-271-2274
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9235422367500000X
FLARNP9235422367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3072134 00Medicaid
FLG3958OtherBCBS
FL3072134 00Medicaid
FLU6127WMedicare PIN
FLG3958OtherBCBS