MEDICARE: ASTRID ARRIETA RPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT10036	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235164831
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASTRID ARRIETA RPT

Provider Business Mailing Address
First Line	:	2926 NW 124TH WAY
Second Line	:
City	:	SUNRISE
State	:	FL
Zip	:	33323-5259
Country	:	US
Telephone Number	:	305-231-5266
Fax Number	:	305-231-5264

Provider Business Practice Location Address
First Line	:	15524 NW 77TH CT
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33016-5804
Country	:	US
Telephone Number	:	305-231-5266
Fax Number	:	305-231-5264

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	03/10/2023

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