Provider Demographics
NPI:1154754414
Name:ARVANITIDOU, IRINA G (APRN)
Entity type:Individual
Prefix:
First Name:IRINA
Middle Name:G
Last Name:ARVANITIDOU
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:IRINA
Other - Middle Name:G
Other - Last Name:BUTUZOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:1250 E HALLANDALE BEACH BLVD STE 605
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-4638
Mailing Address - Country:US
Mailing Address - Phone:954-456-8900
Mailing Address - Fax:855-407-8201
Practice Address - Street 1:1250 E HALLANDALE BEACH BLVD STE 605
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4638
Practice Address - Country:US
Practice Address - Phone:954-456-8900
Practice Address - Fax:855-407-8201
Is Sole Proprietor?:No
Enumeration Date:2013-08-09
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9200798364SF0001X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health