Provider Demographics
NPI:1114946159
Name:ARCEBIDO, ROLANDO GREGORIO (ARNP)
Entity Type:Individual
Prefix:
First Name:ROLANDO
Middle Name:GREGORIO
Last Name:ARCEBIDO
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:547 CLERMONT CT
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-2992
Mailing Address - Country:US
Mailing Address - Phone:954-793-9400
Mailing Address - Fax:305-931-5625
Practice Address - Street 1:21110 BISCAYNE BLVD
Practice Address - Street 2:SUITE 405
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1227
Practice Address - Country:US
Practice Address - Phone:305-937-4400
Practice Address - Fax:305-931-5625
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1051642363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY9440BMedicare ID - Type Unspecified
FLP13169Medicare UPIN