Provider Demographics
NPI:1215170188
Name:DIPTEE, ARUNA LIANE (ARNP)
Entity type:Individual
Prefix:MRS
First Name:ARUNA
Middle Name:LIANE
Last Name:DIPTEE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5401 S CONGRESS AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:ATLANTIS
Mailing Address - State:FL
Mailing Address - Zip Code:33462-6636
Mailing Address - Country:US
Mailing Address - Phone:561-967-5033
Mailing Address - Fax:561-967-8974
Practice Address - Street 1:5401 S CONGRESS AVE STE 102
Practice Address - Street 2:
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462-6636
Practice Address - Country:US
Practice Address - Phone:561-967-5033
Practice Address - Fax:561-967-8974
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9232396363L00000X
GARN259890363L00000X
FLAPRN9232396363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN259890OtherGA NP LICENSE