Provider Demographics
NPI:1356792824
Name:PARKER, ARIANA (PA-C)
Entity type:Individual
Prefix:
First Name:ARIANA
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ARIANA
Other - Middle Name:
Other - Last Name:PUCCI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:900 VILLAGE SQUARE XING STE 290
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4552
Mailing Address - Country:US
Mailing Address - Phone:239-313-2517
Mailing Address - Fax:
Practice Address - Street 1:1295 JACARANDA BLVD
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-4522
Practice Address - Country:US
Practice Address - Phone:941-538-7947
Practice Address - Fax:941-484-1072
Is Sole Proprietor?:No
Enumeration Date:2016-06-27
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9117332363AM0700X
RIPA00891363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical