Healthcare Provider Details

I. General information

NPI: 1548253255
Provider Name (Legal Business Name): RICARDO ARGUELLO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1218 N BROADWAY AVE
BARTOW FL
33830-3343
US

IV. Provider business mailing address

1218 N BROADWAY AVE
BARTOW FL
33830-3343
US

V. Phone/Fax

Practice location:
  • Phone: 863-533-6528
  • Fax: 863-534-3641
Mailing address:
  • Phone: 863-533-6528
  • Fax: 863-534-3641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME0054345
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: