Provider Demographics
NPI:1093469280
Name:NABR MEDICAL GROUP PLLC
Entity Type:Organization
Organization Name:NABR MEDICAL GROUP PLLC
Other - Org Name:NABR MEDICAL GROUP PLLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:ARENAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:866-687-6227
Mailing Address - Street 1:4210 VALLEY RIDGE BLVD STE 131
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA
Mailing Address - State:FL
Mailing Address - Zip Code:32081-5183
Mailing Address - Country:US
Mailing Address - Phone:866-687-6227
Mailing Address - Fax:
Practice Address - Street 1:4210 VALLEY RIDGE BLVD STE 131
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA
Practice Address - State:FL
Practice Address - Zip Code:32081-5183
Practice Address - Country:US
Practice Address - Phone:866-687-6227
Practice Address - Fax:866-687-6227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-07
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty