Healthcare Provider Details

I. General information

NPI: 1437358389
Provider Name (Legal Business Name): DAVID RANKIN ARROWSMITH MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2007
Last Update Date: 11/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 10TH AVE
SHALIMAR FL
32579-1304
US

IV. Provider business mailing address

11 10TH AVE
SHALIMAR FL
32579-1304
US

V. Phone/Fax

Practice location:
  • Phone: 850-651-3376
  • Fax: 850-651-3372
Mailing address:
  • Phone: 850-651-3376
  • Fax: 850-651-3372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberME 23325
License Number StateFL

VIII. Authorized Official

Name: DAVID RANKIN ARROWSMITH
Title or Position: PRESIDENT
Credential: MD
Phone: 850-651-3376