Provider Demographics
NPI:1174098354
Name:ARIAS, JOSHUA (ATC)
Entity type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:
Last Name:ARIAS
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7126 BROWN PELICAN CT
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-4878
Mailing Address - Country:US
Mailing Address - Phone:305-525-0335
Mailing Address - Fax:
Practice Address - Street 1:12500 S APOPKA VINELAND ROAD
Practice Address - Street 2:
Practice Address - City:LAKE BUENA VISTA
Practice Address - State:FL
Practice Address - Zip Code:32836
Practice Address - Country:US
Practice Address - Phone:407-560-5994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-04
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL24532255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer