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General NPI Number Information
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NPI Number | 1164193066
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Entity Type | Organization
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Legal Business Name | ARC DERMATOLOGY PLLC
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Dates
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Enumeration Date | 09/22/2021
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Last Update Date | 09/22/2021
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Provider Practice Location Address
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Address Line | 219 US HIGHWAY 27 N
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City | SEBRING
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State | FL
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Zip | 33870-2132
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Country | US
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Telephone | 863-835-2602
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Fax |
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Provider Business Mailing Address
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Address Line | 4013 LAKE HAVEN BLVD
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City | SEBRING
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State | FL
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Zip | 33875-5258
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Country | US
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Telephone | 863-314-6809
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Fax |
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Authorized Official
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Title or Position | SOLE MANAGER
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Name | DR. ABIMAEL RIVERA-CRUZ
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Credential | MD
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Telephone | 863-835-2602
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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