1487061271 NPI number — MR. ALEX M ARCE D.O.

Table of content: MR. ALEX M ARCE D.O. (NPI 1487061271)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487061271 NPI number — MR. ALEX M ARCE D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ARCE
Provider First Name:
ALEX
Provider Middle Name:
M
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
M

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:
1487061271
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
145 N. 6TH ST.
Provider Second Line Business Mailing Address:
1ST FLOOR
Provider Business Mailing Address City Name:
READING
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19601-3096
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-378-2440
Provider Business Mailing Address Fax Number:
610-378-2441

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3 SHIRCLIFF WAY STE 330
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JACKSONVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32204-4780
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-384-7370
Provider Business Practice Location Address Fax Number:
904-384-7851
Provider Enumeration Date:
07/14/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  OS14766 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207Q00000X , with the licence number: OT015753 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 022548200 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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