Basic Information
| Provider Information | |||||||||
| NPI: | 1063914562 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BRIGANTTY - VAZQUEZ | ||||||||
| FirstName: | ALEXANDER | ||||||||
| MiddleName: | |||||||||
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| NameSuffix: | SR. | ||||||||
| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1329 SW 16TH ST | ||||||||
| Address2: | ROOM 2232 | ||||||||
| City: | GAINESVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32610 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3527330485 | ||||||||
| FaxNumber: | 3522658077 | ||||||||
| Practice Location | |||||||||
| Address1: | 7700 W SUNRISE BLVD | ||||||||
| Address2: | |||||||||
| City: | PLANTATION | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333224113 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9549396588 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/01/2018 | ||||||||
| LastUpdateDate: | 01/14/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | APRN9482935 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 367500000X | 115464 | FL | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.