| Richard J Pena- Ariet Md Pa | |
|
1420 Sw Saint Lucie West Blvd Ste 107 Port Saint Lucie FL 34986-1709 | |
| (772) 879-1112 | |
| (772) 879-1167 |
| Full Name | Richard J Pena- Ariet Md Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 1420 Sw Saint Lucie West Blvd Ste 107, Port Saint Lucie, Florida |
| Authorized Official Name and Position | Richard J Pena Ariet (PRESIDENT) |
| Authorized Official Contact | 7728791112 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Richard J Pena- Ariet Md Pa 1420 Sw Saint Lucie West Blvd Ste 107 Port Saint Lucie FL 34986-1709 Ph: (772) 879-1112 | Richard J Pena- Ariet Md Pa 1420 Sw Saint Lucie West Blvd Ste 107 Port Saint Lucie FL 34986-1709 Ph: (772) 879-1112 |
| NPI Number | 1609804624 |
|---|---|
| Provider Enumeration Date | 06/29/2006 |
| Last Update Date | 12/13/2019 |
| Medicare PECOS PAC ID | 4183705445 |
|---|---|
| Medicare Enrollment ID | O20080114000203 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609804624 | NPI | - | NPPES |
| 7184385 | Other | FL | AETNA |
| 265063100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Florida) | Primary |
| Provider Name | Richard J Pena-ariet |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225015852 PECOS PAC ID: 8325138332 Enrollment ID: I20071214000097 |
| Provider Name | Kristina Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063871341 PECOS PAC ID: 3971875758 Enrollment ID: I20170815001968 |
| Provider Name | Eduardo Castro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558903104 PECOS PAC ID: 1850711888 Enrollment ID: I20201013002781 |
| Provider Name | Michelle Gozar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811480437 PECOS PAC ID: 8224432299 Enrollment ID: I20210812002650 |
| Provider Name | Alexander Friman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699482463 PECOS PAC ID: 6608221163 Enrollment ID: I20231018003183 |
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