Healthcare Provider Details

I. General information

NPI: 1528071289
Provider Name (Legal Business Name): JUAN PABLO ARNOLETTI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 08/19/2020
Certification Date: 08/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 N ORANGE AVE STE 201
ORLANDO FL
32804-4641
US

IV. Provider business mailing address

2501 N ORANGE AVE STE 201
ORLANDO FL
32804-4641
US

V. Phone/Fax

Practice location:
  • Phone: 407-821-3620
  • Fax: 407-821-3621
Mailing address:
  • Phone: 407-821-3620
  • Fax: 407-821-3621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number24732
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberME113251
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: