MEDICARE: DR. TERRY L ARCH O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OPC2223	FL

General Provider Information

NPI Number	:	1598946964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TERRY L ARCH O.D.

Provider Business Mailing Address
First Line	:	2016 N WESTMORELAND DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-5746
Country	:	US
Telephone Number	:	407-694-3228
Fax Number	:

Provider Business Practice Location Address
First Line	:	2016 N WESTMORELAND DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32804-5746
Country	:	US
Telephone Number	:	407-694-3228
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2007
Last Update Date	:	11/14/2007

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