Provider Demographics
NPI:1891105763
Name:AMARO NODARSE, ARQUIMIDE
Entity Type:Individual
Prefix:
First Name:ARQUIMIDE
Middle Name:
Last Name:AMARO NODARSE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7371 SW 24TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-1402
Mailing Address - Country:US
Mailing Address - Phone:786-360-4051
Mailing Address - Fax:305-456-6647
Practice Address - Street 1:7371 SW 24TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1402
Practice Address - Country:US
Practice Address - Phone:786-360-4051
Practice Address - Fax:305-456-6647
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-01
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11016310363LF0000X
246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant