Provider Demographics
NPI:1205215985
Name:BECKER, ARIANNA EVA (DO)
Entity Type:Individual
Prefix:
First Name:ARIANNA
Middle Name:EVA
Last Name:BECKER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ARIANNA
Other - Middle Name:EVA
Other - Last Name:GRIMM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2005 MIZELL AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792
Mailing Address - Country:US
Mailing Address - Phone:407-646-7380
Mailing Address - Fax:407-646-7381
Practice Address - Street 1:2005 MIZELL AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792
Practice Address - Country:US
Practice Address - Phone:407-646-7380
Practice Address - Fax:407-646-7381
Is Sole Proprietor?:No
Enumeration Date:2015-05-27
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLOS14278207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program