Provider Demographics
NPI:1487472007
Name:ARIAS, CATHERINE MARIE
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:MARIE
Last Name:ARIAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9204 GREENBRIER CT
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-6735
Mailing Address - Country:US
Mailing Address - Phone:954-881-2687
Mailing Address - Fax:
Practice Address - Street 1:4341 BOUGAINVILLA DR
Practice Address - Street 2:
Practice Address - City:LAUDERDALE BY THE SEA
Practice Address - State:FL
Practice Address - Zip Code:33308-5017
Practice Address - Country:US
Practice Address - Phone:954-492-8866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-02
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant