Provider Demographics
NPI:1720450166
Name:APONTE III, EUDALDO (MSN, APRN , PMHNP-BC)
Entity Type:Individual
Prefix:MR
First Name:EUDALDO
Middle Name:
Last Name:APONTE III
Suffix:
Gender:M
Credentials:MSN, APRN , PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5951 NW 173RD DR
Mailing Address - Street 2:SUITE 7
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-5112
Mailing Address - Country:US
Mailing Address - Phone:305-557-1030
Mailing Address - Fax:305-456-3290
Practice Address - Street 1:5951 NW 173RD DR
Practice Address - Street 2:SUITE 7
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-5112
Practice Address - Country:US
Practice Address - Phone:305-557-1030
Practice Address - Fax:305-456-3290
Is Sole Proprietor?:No
Enumeration Date:2015-10-26
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9313555363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016095200Medicaid