Provider Demographics
NPI:1871897843
Name:BRIDGES, ARLETTE (MS)
Entity type:Individual
Prefix:
First Name:ARLETTE
Middle Name:
Last Name:BRIDGES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5028 PARK CENTRAL DR APT 2125
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32839-5378
Mailing Address - Country:US
Mailing Address - Phone:407-953-5374
Mailing Address - Fax:
Practice Address - Street 1:8628 SHIRE RIDGE LOOP
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32309-7483
Practice Address - Country:US
Practice Address - Phone:407-953-5374
Practice Address - Fax:800-449-9758
Is Sole Proprietor?:No
Enumeration Date:2011-01-05
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
376J00000X, 101Y00000X
FL234961376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1871897843Medicaid
FL014304100Medicaid