Provider Demographics
NPI:1902366719
Name:URQUIZA MILIAN, ARIADNIS (MD)
Entity Type:Individual
Prefix:
First Name:ARIADNIS
Middle Name:
Last Name:URQUIZA MILIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 S WOODLAND ST
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-3546
Mailing Address - Country:US
Mailing Address - Phone:407-905-8827
Mailing Address - Fax:407-905-8899
Practice Address - Street 1:212 E MAIN ST
Practice Address - Street 2:
Practice Address - City:TAVARES
Practice Address - State:FL
Practice Address - Zip Code:32778-3808
Practice Address - Country:US
Practice Address - Phone:407-905-8827
Practice Address - Fax:352-742-3264
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR021422208D00000X
FLACN1174208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice