=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013351766
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PLASTIC SURGERY OF CENTRAL FLORIDA, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/24/2013
-----------------------------------------------------
Last Update Date | 04/24/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 95 WEST KALEY ST
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32806
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-704-3337
-----------------------------------------------------
Fax | 407-730-3878
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 95 W KALEY ST
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32806-2943
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 407-704-3337
-----------------------------------------------------
Fax | 407-730-3878
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN
-----------------------------------------------------
Name | DR. RICHARD ARABITG
-----------------------------------------------------
Credential | M.D
-----------------------------------------------------
Telephone | 407-704-3337
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208200000X
-----------------------------------------------------
Taxonomy Name | Plastic Surgery Physician
-----------------------------------------------------
License Number | ME69082
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------