Healthcare Provider Details
I. General information
NPI: 1790182988
Provider Name (Legal Business Name): ARCADIA PEDIATRICS PLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/03/2014
Last Update Date: 12/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1014 N MILLS AVE
ARCADIA FL
34266-8811
US
IV. Provider business mailing address
1014 N MILLS AVE
ARCADIA FL
34266-8811
US
V. Phone/Fax
- Phone: 863-494-1553
- Fax: 863-494-9492
- Phone: 863-494-1553
- Fax: 863-494-9492
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
PEDRO
R.
VILLANUEVA
Title or Position: OWNER
Credential: MD
Phone: 863-494-1553