Provider Demographics
NPI:1134898448
Name:ARROYO-NIETO, ELDER ANTONIO (MD)
Entity type:Individual
Prefix:
First Name:ELDER
Middle Name:ANTONIO
Last Name:ARROYO-NIETO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 FERN DR
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-7008
Mailing Address - Country:US
Mailing Address - Phone:352-705-3484
Mailing Address - Fax:
Practice Address - Street 1:3725 S HWY 27 STE 101
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-7600
Practice Address - Country:US
Practice Address - Phone:352-524-2067
Practice Address - Fax:352-242-1335
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-09
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN1410208D00000X
PR22521208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice