Healthcare Provider Details

I. General information

NPI: 1235164831
Provider Name (Legal Business Name): ASTRID ARRIETA RPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 03/10/2023
Certification Date: 03/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15524 NW 77TH CT
MIAMI LAKES FL
33016-5804
US

IV. Provider business mailing address

2926 NW 124TH WAY
SUNRISE FL
33323-5259
US

V. Phone/Fax

Practice location:
  • Phone: 305-231-5266
  • Fax: 305-231-5264
Mailing address:
  • Phone: 305-231-5266
  • Fax: 305-231-5264

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT10036
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: