MEDICARE: MR. ARMANDO CONTRERAS ARNP

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	363LA2200X	Adult Health Nurse Practitioner	ARNP9200835	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	:	1376567701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ARMANDO CONTRERAS ARNP

Provider Business Mailing Address
First Line	:	95 BULLDOG BLVD STE 202
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32901-3188
Country	:	US
Telephone Number	:	321-725-2225
Fax Number	:	321-308-0635

Provider Business Practice Location Address
First Line	:	1344 S APOLLO BLVD STE 300
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32901-3185
Country	:	US
Telephone Number	:	321-725-2225
Fax Number	:	321-308-0635

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

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	02/14/2022

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