Basic Information
Provider Information
NPI: 1356798474
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARROYO
FirstName: SIRENIA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 616788
Address2:  
City: ORLANDO
State: FL
PostalCode: 328616788
CountryCode: US
TelephoneNumber: 4074477120
FaxNumber: 4077700661
Practice Location
Address1: 309 W BASS STREET
Address2:  
City: KISSIMMEE
State: FL
PostalCode: 34741
CountryCode: US
TelephoneNumber: 4079351192
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/18/2016
LastUpdateDate: 08/21/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XARNP9382177FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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