Provider Demographics
NPI:1235253790
Name:ARCE, ISRAEL
Entity Type:Individual
Prefix:MR
First Name:ISRAEL
Middle Name:
Last Name:ARCE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:KENNY
Other - Middle Name:
Other - Last Name:ARCE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:URB.VENTURINI ST.5 #D30
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685
Mailing Address - Country:US
Mailing Address - Phone:787-896-5954
Mailing Address - Fax:787-896-1154
Practice Address - Street 1:URB.VENTURINI ST.5 #D30
Practice Address - Street 2:M.J. CABRERO 54
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685
Practice Address - Country:US
Practice Address - Phone:787-896-5954
Practice Address - Fax:787-896-1154
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0903018183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR003018OtherSTATE LIC.