Healthcare Provider Details

I. General information

NPI: 1861663700
Provider Name (Legal Business Name): BRUCE DUANE ARNOLD R.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2008
Last Update Date: 03/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5750 FALL RIVER DR
NEW PORT RICHEY FL
34655-1114
US

IV. Provider business mailing address

5750 FALL RIVER DR
NEW PORT RICHEY FL
34655-1114
US

V. Phone/Fax

Practice location:
  • Phone: 727-375-9323
  • Fax: 727-376-7376
Mailing address:
  • Phone: 727-375-9323
  • Fax: 727-376-7376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License NumberCRT 52970
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: