Healthcare Provider Details

I. General information

NPI: 1225513682
Provider Name (Legal Business Name): FLORIDA ARISTY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2018
Last Update Date: 06/04/2024
Certification Date: 06/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 SE INDIAN ST STE 102
STUART FL
34997-5765
US

IV. Provider business mailing address

1652 SW MACKEY AVE
PORT SAINT LUCIE FL
34953-4732
US

V. Phone/Fax

Practice location:
  • Phone: 772-675-0000
  • Fax:
Mailing address:
  • Phone: 561-797-1288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9312276
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: