Provider Demographics
NPI:1154061414
Name:ARRUDA, FERNANDA PONCE DE LEON (MA)
Entity Type:Individual
Prefix:
First Name:FERNANDA
Middle Name:PONCE DE LEON
Last Name:ARRUDA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2233 N COMMERCE PKWY STE 3
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-3252
Mailing Address - Country:US
Mailing Address - Phone:954-217-1795
Mailing Address - Fax:
Practice Address - Street 1:2233 N COMMERCE PKWY STE 3
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3252
Practice Address - Country:US
Practice Address - Phone:954-217-1795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-01
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician