Provider Demographics
NPI:1790961035
Name:MERRILL PRIETO ARNP INC
Entity Type:Organization
Organization Name:MERRILL PRIETO ARNP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MERRILL
Authorized Official - Middle Name:HOPE
Authorized Official - Last Name:PRIETO
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:954-389-3960
Mailing Address - Street 1:590 CARRINGTON DR
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-3571
Mailing Address - Country:US
Mailing Address - Phone:954-389-3960
Mailing Address - Fax:954-389-3960
Practice Address - Street 1:590 CARRINGTON DR
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3571
Practice Address - Country:US
Practice Address - Phone:954-389-3960
Practice Address - Fax:954-389-3960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-17
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2630372363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty