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General NPI Number Information
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NPI Number | 1972802817
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Entity Type | Individual
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Provider Name | ARTURO MANUEL BACA-ARUS OPTICIAN
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Gender | Male
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Dates
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Enumeration Date | 03/17/2011
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Last Update Date | 03/17/2011
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Provider Practice Location Address
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Address Line | 8485 SW 40TH ST SUITE 103
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City | MIAMI
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State | FL
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Zip | 33155-3244
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Country | US
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Telephone | 305-223-6142
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Fax | 305-552-0824
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Provider Business Mailing Address
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Address Line | 8485 SW 40TH ST SUITE 103
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City | MIAMI
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State | FL
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Zip | 33155-3244
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Country | US
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Telephone | 305-223-6142
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Fax | 305-552-0824
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | DO6271
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License Number State | FL
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