Provider Demographics
NPI:1164871463
Name:ARC DERMATOLOGY INC.
Entity Type:Organization
Organization Name:ARC DERMATOLOGY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DERMATOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ABIMAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-995-7435
Mailing Address - Street 1:PO BOX 454
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-0454
Mailing Address - Country:US
Mailing Address - Phone:787-995-7435
Mailing Address - Fax:939-399-3376
Practice Address - Street 1:6777 MARGINAL AVE ISLA VERDE
Practice Address - Street 2:ISLA VERDE MALL SUITE 213
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979
Practice Address - Country:US
Practice Address - Phone:787-995-7435
Practice Address - Fax:939-399-3376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-07
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty