NPI Code Details Logo

NPI 1083493860

NPI 1083493860 : ALTEA MEDICAL FLORIDA PLLC : SAINT CLOUD, FL

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1083493860
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    ALTEA MEDICAL FLORIDA PLLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    09/21/2023
-----------------------------------------------------
    Last Update Date     |    11/13/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    4641 OLD CANOE CREEK RD 
-----------------------------------------------------
    City                 |    SAINT CLOUD
-----------------------------------------------------
    State                |    FL
-----------------------------------------------------
    Zip                  |    34769-1550
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    888-408-7008
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    400 E RIVULON BLVD STE 103 
-----------------------------------------------------
    City                 |    GILBERT
-----------------------------------------------------
    State                |    AZ
-----------------------------------------------------
    Zip                  |    85297-0096
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    DIRECTOR OF RCM
-----------------------------------------------------
    Name                 |     MARY BELEN ARNDT 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    775-287-3290
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    207R00000X
-----------------------------------------------------
    Taxonomy Name        |    Internal Medicine Physician
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    207QA0505X
-----------------------------------------------------
    Taxonomy Name        |    Adult Medicine Physician
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
    Taxonomy Code        |    208100000X
-----------------------------------------------------
    Taxonomy Name        |    Physical Medicine & Rehabilitation Physician
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
    Taxonomy Code        |    207RG0300X
-----------------------------------------------------
    Taxonomy Name        |    Geriatric Medicine (Internal Medicine) Physician
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.