Provider Demographics
NPI:1477199552
Name:QUEVEDO, ARLENE (BSN, RN)
Entity Type:Individual
Prefix:
First Name:ARLENE
Middle Name:
Last Name:QUEVEDO
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:471 ARBOR LAKES DR
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33896-8196
Mailing Address - Country:US
Mailing Address - Phone:786-201-7576
Mailing Address - Fax:
Practice Address - Street 1:471 ARBOR LAKES DR
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33896-8196
Practice Address - Country:US
Practice Address - Phone:786-201-7576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-22
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9456012163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-SurgicalGroup - Single Specialty