Provider Demographics
NPI:1699469056
Name:ROBLES SERRANO, JASHUA STEVENS (CRNA)
Entity type:Individual
Prefix:
First Name:JASHUA
Middle Name:STEVENS
Last Name:ROBLES SERRANO
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 1:17851 BELLAVISTA LOOP UNIT 432
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558-5689
Mailing Address - Country:US
Mailing Address - Phone:787-206-5353
Mailing Address - Fax:
Practice Address - Street 1:17851 BELLAVISTA LOOP UNIT 432
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33558-5689
Practice Address - Country:US
Practice Address - Phone:787-206-5353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-07
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11021378367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered