Provider Demographics
NPI:1194319145
Name:ARIAS LEON, EDUARDO ANTONIO (APRN)
Entity type:Individual
Prefix:DR
First Name:EDUARDO
Middle Name:ANTONIO
Last Name:ARIAS LEON
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9015 NW 164TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33018-6191
Mailing Address - Country:US
Mailing Address - Phone:786-317-7162
Mailing Address - Fax:
Practice Address - Street 1:9015 NW 164TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33018-6191
Practice Address - Country:US
Practice Address - Phone:786-317-7162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-21
Last Update Date:2021-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11011543363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty