Provider Demographics
NPI:1134332109
Name:NAU, RONALD (ARNP)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:
Last Name:NAU
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9780 E INDIGO ST
Mailing Address - Street 2:STE 204
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-5610
Mailing Address - Country:US
Mailing Address - Phone:407-648-5343
Mailing Address - Fax:407-648-5023
Practice Address - Street 1:2840 N HIAWASSEE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32818-3319
Practice Address - Country:US
Practice Address - Phone:407-378-6288
Practice Address - Fax:407-648-5023
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2576172363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL007378600Medicaid