Provider Demographics
NPI:1457194680
Name:VIDAL, ARIS DANIEL (RN, SRNA)
Entity type:Individual
Prefix:
First Name:ARIS
Middle Name:DANIEL
Last Name:VIDAL
Suffix:
Gender:M
Credentials:RN, SRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4745 AVE ISLA VERDE APT 14L
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979-5425
Mailing Address - Country:US
Mailing Address - Phone:813-810-8642
Mailing Address - Fax:
Practice Address - Street 1:4745 AVE ISLA VERDE APT 14L
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979-5425
Practice Address - Country:US
Practice Address - Phone:813-810-8642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-15
Last Update Date:2024-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program