Provider Demographics
NPI:1750652814
Name:ARLETTE N. SHVARTZMAN MD;PA
Entity Type:Organization
Organization Name:ARLETTE N. SHVARTZMAN MD;PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ARLETTE
Authorized Official - Middle Name:NADIRA
Authorized Official - Last Name:SHVARTZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-945-6788
Mailing Address - Street 1:825 PONTE VEDRA BLVD
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32082-3402
Mailing Address - Country:US
Mailing Address - Phone:904-945-6788
Mailing Address - Fax:
Practice Address - Street 1:825 PONTE VEDRA BLVD
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32082-3402
Practice Address - Country:US
Practice Address - Phone:904-945-6788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-21
Last Update Date:2012-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME76699174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL255200100Medicaid
FL255200100Medicaid
FLG62892Medicare UPIN