=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982860797
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ARIEL FIGUEREDO MD PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/31/2008
-----------------------------------------------------
Last Update Date | 05/12/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 602 SE 16TH PL
-----------------------------------------------------
City | CAPE CORAL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33990-1684
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 239-573-7222
-----------------------------------------------------
Fax | 239-573-6122
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 602 SE 16TH PL
-----------------------------------------------------
City | CAPE CORAL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33990-1684
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 239-573-7222
-----------------------------------------------------
Fax | 239-573-6122
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRACTICE ADMINISTRATOR
-----------------------------------------------------
Name | MAYLENI HERNANDEZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 239-573-7222
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | ME92164
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------