Healthcare Provider Details

I. General information

NPI: 1245269331
Provider Name (Legal Business Name): ROBERTO AREVALO-ARAUJO MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 08/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 US HIGHWAY 19
HOLIDAY FL
34691-2635
US

IV. Provider business mailing address

3000 US HIGHWAY 19
HOLIDAY FL
34691-2635
US

V. Phone/Fax

Practice location:
  • Phone: 727-849-6690
  • Fax: 727-848-3771
Mailing address:
  • Phone: 727-942-7070
  • Fax: 727-934-9457

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERTO A ARAUJO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 727-942-7070