Provider Demographics
NPI:1659150001
Name:NIETO, EDUARDO E (ARNP)
Entity type:Individual
Prefix:
First Name:EDUARDO
Middle Name:E
Last Name:NIETO
Suffix:
Gender:
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3850 COCONUT CREEK PKWY STE 3
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33066-1600
Mailing Address - Country:US
Mailing Address - Phone:954-973-9222
Mailing Address - Fax:954-973-7135
Practice Address - Street 1:3850 COCONUT CREEK PKWY STE 3
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33066-1600
Practice Address - Country:US
Practice Address - Phone:954-973-9222
Practice Address - Fax:954-973-7135
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-25
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF08230440363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily