1164871463 NPI number — ARC DERMATOLOGY INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164871463 NPI number — ARC DERMATOLOGY INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARC DERMATOLOGY INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164871463
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/06/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 454
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DORADO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00646-0454
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-995-7435
Provider Business Mailing Address Fax Number:
939-399-3376

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6777 MARGINAL AVE ISLA VERDE
Provider Second Line Business Practice Location Address:
ISLA VERDE MALL SUITE 213
Provider Business Practice Location Address City Name:
CAROLINA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00979
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-995-7435
Provider Business Practice Location Address Fax Number:
939-399-3376
Provider Enumeration Date:
06/07/2016

Additional Information

Authorized Official

Authorized Official Last Name:
RIVERA CRUZ
Authorized Official First Name:
ABIMAEL
Authorized Official Middle Name:
Authorized Official Title or Position:
DERMATOLOGIST
Authorized Official Telephone Number:
787-995-7435

Provider Taxonomy Codes

  • Taxonomy code: 207N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com