Provider Demographics
NPI:1235882168
Name:BALUJA ECHEVARRIA, ARNOVIS (APRN)
Entity Type:Individual
Prefix:
First Name:ARNOVIS
Middle Name:
Last Name:BALUJA ECHEVARRIA
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2675 WINKLER AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9342
Mailing Address - Country:US
Mailing Address - Phone:877-856-3774
Mailing Address - Fax:
Practice Address - Street 1:9400 GLADIOLUS DR STE 50
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-9615
Practice Address - Country:US
Practice Address - Phone:239-437-7070
Practice Address - Fax:239-437-9022
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-31
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11016973363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily