Provider Demographics
NPI:1629396486
Name:ARIAS-URDANETA, LUIS A (MD)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:A
Last Name:ARIAS-URDANETA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 NE 95TH ST SUITE 4
Mailing Address - Street 2:
Mailing Address - City:MIAMI SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33138-2745
Mailing Address - Country:US
Mailing Address - Phone:786-206-8610
Mailing Address - Fax:786-206-8612
Practice Address - Street 1:209 NE 95TH ST SUITE 4
Practice Address - Street 2:
Practice Address - City:MIAMI SHORES
Practice Address - State:FL
Practice Address - Zip Code:33138-2745
Practice Address - Country:US
Practice Address - Phone:786-206-8610
Practice Address - Fax:786-206-8612
Is Sole Proprietor?:No
Enumeration Date:2010-05-04
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAL-243019207R00000X
FLME106280207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine