Provider Demographics
NPI:1790482776
Name:ARIEL FIGUEREDO MD PA
Entity Type:Organization
Organization Name:ARIEL FIGUEREDO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FIGUEREDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-573-7222
Mailing Address - Street 1:602 SE 16TH PL
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-1684
Mailing Address - Country:US
Mailing Address - Phone:239-573-7222
Mailing Address - Fax:239-573-6122
Practice Address - Street 1:11760 SW 40TH ST STE 311
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3595
Practice Address - Country:US
Practice Address - Phone:786-953-8233
Practice Address - Fax:305-262-9897
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARIEL FIGUEREDO MD PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-02-10
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL114363800Medicaid