Provider Demographics
NPI:1033849427
Name:ARZUAGA, MARIA LADISLADA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:LADISLADA
Last Name:ARZUAGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1735 E 36TH ST
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44055-2503
Mailing Address - Country:US
Mailing Address - Phone:440-396-8283
Mailing Address - Fax:
Practice Address - Street 1:2709 BROADWAY
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44052-4835
Practice Address - Country:US
Practice Address - Phone:440-244-1950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH09214748183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician