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NPI Code Detail

MEDICARE: ARISTA MINK

MEDICARE: ARISTA MINK
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1700738986
Entity Type Code : Individual
Provider Name (Legal Business Name) : ARISTA MINK
Provider Business Mailing Address
First Line : 2220 COUNTY ROAD 210 WEST
Second Line : SUITE 108, PMB 169
City : JACKSONVILLE
State : FL
Zip : 32259
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6339 ARGYLE FOREST BLVD STE 4
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32244-6601
Country : US
Telephone Number : 904-613-5005
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2026
Last Update Date : 02/11/2026

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Directions to “ ARISTA MINK ” Practice Location

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