Provider Demographics
NPI:1487353157
Name:ARIEL FIGUEREDO MD, PA
Entity type:Organization
Organization Name:ARIEL FIGUEREDO MD, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FIGUEREDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-573-7222
Mailing Address - Street 1:4232 ERINDALE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33903-5030
Mailing Address - Country:US
Mailing Address - Phone:239-233-5572
Mailing Address - Fax:
Practice Address - Street 1:602 SE 16TH PL
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-1684
Practice Address - Country:US
Practice Address - Phone:239-233-5572
Practice Address - Fax:239-573-6122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-01
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL275666800Medicaid