Provider Demographics
NPI:1871230268
Name:ARIAS, ISLEYDIS (APRN)
Entity Type:Individual
Prefix:
First Name:ISLEYDIS
Middle Name:
Last Name:ARIAS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13670 METROPOLIS AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-4346
Mailing Address - Country:US
Mailing Address - Phone:239-410-9453
Mailing Address - Fax:
Practice Address - Street 1:13670 METROPOLIS AVE STE 101
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-4346
Practice Address - Country:US
Practice Address - Phone:239-410-9453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11019129363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLA620400857820OtherDRIVER LICENSE