Healthcare Provider Details

I. General information

NPI: 1457630451
Provider Name (Legal Business Name): JOSE R ARNAO O.D. P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2011
Last Update Date: 08/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6757 W NEWBERRY RD
GAINESVILLE FL
32605-4312
US

IV. Provider business mailing address

3676 NW 23RD DR APT 108
GAINESVILLE FL
32605-5676
US

V. Phone/Fax

Practice location:
  • Phone: 352-331-2040
  • Fax: 352-331-1526
Mailing address:
  • Phone: 954-347-0435
  • Fax: 352-505-6416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPC4293
License Number StateFL

VIII. Authorized Official

Name: DR. JOSE ROBERTO ARNAO
Title or Position: PRESIDENT
Credential: O.D.
Phone: 954-347-0435