Provider Demographics
NPI:1235164831
Name:ARRIETA, ASTRID (RPT)
Entity Type:Individual
Prefix:
First Name:ASTRID
Middle Name:
Last Name:ARRIETA
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2926 NW 124TH WAY
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-5259
Mailing Address - Country:US
Mailing Address - Phone:305-231-5266
Mailing Address - Fax:305-231-5264
Practice Address - Street 1:15524 NW 77TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-5804
Practice Address - Country:US
Practice Address - Phone:305-231-5266
Practice Address - Fax:305-231-5264
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT10036225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL888756000Medicaid