Healthcare Provider Details

I. General information

NPI: 1225822596
Provider Name (Legal Business Name): ROBERTO NARANJO ARIAS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2025
Last Update Date: 04/12/2025
Certification Date: 04/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7911 NW 72ND AVE
MEDLEY FL
33166-2227
US

IV. Provider business mailing address

9850 HAMMOCKS BLVD APT 106
MIAMI FL
33196-1583
US

V. Phone/Fax

Practice location:
  • Phone: 305-887-1005
  • Fax:
Mailing address:
  • Phone: 409-332-2516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11038702
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: