MEDICARE: DR. YOLANDA ARCE-MONTIJO O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	3940-35	WI
2	152W00000X	Optometrist	449	PR
3	152W00000X	Optometrist	046010746	IL

General Provider Information

NPI Number	:	1063491553
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YOLANDA ARCE-MONTIJO O.D.

Provider Business Mailing Address
First Line	:	200 1ST ST SW
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55905-0001
Country	:	US
Telephone Number	:	507-284-2511
Fax Number	:

Provider Business Practice Location Address
First Line	:	331 W 1ST DR
Second Line	:
City	:	DECATUR
State	:	IL
Zip	:	62521-5207
Country	:	US
Telephone Number	:	217-422-3881
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2006
Last Update Date	:	02/09/2024

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