MEDICARE: ARC DERMATOLOGY LLC

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	207N00000X	Dermatology Physician

General Provider Information

NPI Number	:	1164871463
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARC DERMATOLOGY LLC

Provider Business Mailing Address
First Line	:	HC 5 BOX 92257
Second Line	:
City	:	ARECIBO
State	:	PR
Zip	:	00612-9539
Country	:	US
Telephone Number	:	787-956-0020
Fax Number	:	787-956-0019

Provider Business Practice Location Address
First Line	:	CARR 653 KM 2.2
Second Line	:	SECTOR BARRANCA
City	:	ARECIBO
State	:	PR
Zip	:	00612
Country	:	US
Telephone Number	:	787-956-0020
Fax Number	:	787-956-0019

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ABIMAEL RIVERA-CRUZ
Credential	:	MD
Telephone Number	:	787-956-0020

Provider Enumeration Date	:	06/07/2016
Last Update Date	:	01/29/2026

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