Provider Demographics
NPI:1376567701
Name:CONTRERAS, ARMANDO (ARNP)
Entity Type:Individual
Prefix:MR
First Name:ARMANDO
Middle Name:
Last Name:CONTRERAS
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 1:95 BULLDOG BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-3188
Mailing Address - Country:US
Mailing Address - Phone:321-725-2225
Mailing Address - Fax:321-308-0635
Practice Address - Street 1:1344 S APOLLO BLVD STE 300
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-3185
Practice Address - Country:US
Practice Address - Phone:321-725-2225
Practice Address - Fax:321-308-0635
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9200835363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL308635600Medicaid
FLAH247WMedicare PIN
FLAH247XMedicare PIN