Provider Demographics
NPI:1730690991
Name:LE, ARIEL (MMS, PA-C)
Entity type:Individual
Prefix:
First Name:ARIEL
Middle Name:
Last Name:LE
Suffix:
Gender:F
Credentials:MMS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9056 ALEXANDRA CIR
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-6440
Mailing Address - Country:US
Mailing Address - Phone:954-823-2110
Mailing Address - Fax:
Practice Address - Street 1:9056 ALEXANDRA CIR
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-6440
Practice Address - Country:US
Practice Address - Phone:954-829-2110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-16
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9110857363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant