Provider Demographics
NPI:1104635671
Name:ARCILA, VIVIANA
Entity type:Individual
Prefix:
First Name:VIVIANA
Middle Name:
Last Name:ARCILA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20916 SW 89TH PL
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-7372
Mailing Address - Country:US
Mailing Address - Phone:305-798-1903
Mailing Address - Fax:
Practice Address - Street 1:20916 SW 89TH PL
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189-7372
Practice Address - Country:US
Practice Address - Phone:305-798-1903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11034729363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care