Healthcare Provider Details

I. General information

NPI: 1770414302
Provider Name (Legal Business Name): YOANQUI ARIAS PCT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3921 WHITEDOVE DR
LAKELAND FL
33812-4165
US

IV. Provider business mailing address

3921 WHITEDOVE DR
LAKELAND FL
33812-4165
US

V. Phone/Fax

Practice location:
  • Phone: 305-305-4010
  • Fax:
Mailing address:
  • Phone: 305-305-4010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License NumberA201393915000
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: