Provider Demographics
NPI:1972937159
Name:ARRIETA, NESTOR EDUARDO (AA)
Entity type:Individual
Prefix:
First Name:NESTOR
Middle Name:EDUARDO
Last Name:ARRIETA
Suffix:
Gender:M
Credentials:AA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5680 WINGHAM WAY
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463-6695
Mailing Address - Country:US
Mailing Address - Phone:561-253-4091
Mailing Address - Fax:
Practice Address - Street 1:2200 N FLORIDA MANGO RD
Practice Address - Street 2:SUITE 402
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-6404
Practice Address - Country:US
Practice Address - Phone:561-855-4993
Practice Address - Fax:561-899-4995
Is Sole Proprietor?:No
Enumeration Date:2013-08-24
Last Update Date:2013-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker