Provider Demographics
NPI:1932718731
Name:DE LA CALLE, ARLETYS (PA-C)
Entity Type:Individual
Prefix:
First Name:ARLETYS
Middle Name:
Last Name:DE LA CALLE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1197 MYSTIC WAY
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-5611
Mailing Address - Country:US
Mailing Address - Phone:786-451-8994
Mailing Address - Fax:
Practice Address - Street 1:9121 N MILITARY TRL STE 102
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-5985
Practice Address - Country:US
Practice Address - Phone:561-619-2460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-28
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9113060363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant