Provider Demographics
NPI:1659420628
Name:LATHROP, KEITH (CRNA)
Entity type:Individual
Prefix:
First Name:KEITH
Middle Name:
Last Name:LATHROP
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9500 S DADELAND BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-2866
Mailing Address - Country:US
Mailing Address - Phone:786-530-3820
Mailing Address - Fax:
Practice Address - Street 1:14904 RICHMOND HWY STE 104
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3908
Practice Address - Country:US
Practice Address - Phone:703-497-4222
Practice Address - Fax:703-492-0164
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024173719367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered