Provider Demographics
NPI:1013442920
Name:BAGARRA, ALDEN ALVES (ARNP)
Entity Type:Individual
Prefix:MR
First Name:ALDEN
Middle Name:ALVES
Last Name:BAGARRA
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5263 MARBELLA ISLE DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-4748
Mailing Address - Country:US
Mailing Address - Phone:407-601-2067
Mailing Address - Fax:407-601-2067
Practice Address - Street 1:5263 MARBELLA ISLE DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-4748
Practice Address - Country:US
Practice Address - Phone:407-601-2067
Practice Address - Fax:407-601-2067
Is Sole Proprietor?:No
Enumeration Date:2017-04-28
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9291480363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily