Healthcare Provider Details

I. General information

NPI: 1225096100
Provider Name (Legal Business Name): ARNEL MEDICAL OFFICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 04/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6501 NW 36TH ST SUITE 456
VIRGINIA GARDENS FL
33166-6959
US

IV. Provider business mailing address

6501 NW 36TH ST SUITE 456
VIRGINIA GARDENS FL
33166-6959
US

V. Phone/Fax

Practice location:
  • Phone: 305-871-6151
  • Fax: 305-871-6153
Mailing address:
  • Phone: 305-871-6151
  • Fax: 305-871-6153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberHCC3741
License Number StateFL

VIII. Authorized Official

Name: ROBERTO FALCON JR.
Title or Position: PRESIDENT
Credential:
Phone: 305-871-6151