Healthcare Provider Details

I. General information

NPI: 1700222841
Provider Name (Legal Business Name): CHERRYL ARROYO MORENO M.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHERRYL CAPANAS ARROYO M.T.

II. Dates (important events)

Enumeration Date: 05/15/2013
Last Update Date: 05/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 COMMERCE DR
FRANKLIN IN
46131-7310
US

IV. Provider business mailing address

2267 SEATTLE SLEW DR
INDIANAPOLIS IN
46234-7663
US

V. Phone/Fax

Practice location:
  • Phone: 317-946-5848
  • Fax: 317-736-4321
Mailing address:
  • Phone: 317-946-5848
  • Fax: 317-736-4321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246QM0706X
TaxonomyMedical Technologist
License Number010784
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code247ZC0005X
TaxonomyClinical Laboratory Director (Non-physician)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: