MEDICARE: ARIEL FUENTES

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	207P00000X	Emergency Medicine Physician	ME173240	FL

General Provider Information

NPI Number	:	1548919707
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARIEL FUENTES

Provider Business Mailing Address
First Line	:	1611 NW 12TH AVE
Second Line	:	ECC1135
City	:	MIAMI
State	:	FL
Zip	:	33136-1096
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1611 NW 12TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33136-1005
Country	:	US
Telephone Number	:	305-585-1111
Fax Number	:

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

Provider Enumeration Date	:	03/23/2022
Last Update Date	:	01/15/2026

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Directions to “ ARIEL FUENTES ” Practice Location

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