Provider Demographics
NPI:1326359530
Name:ARCIS, PEDRO R (APRN)
Entity Type:Individual
Prefix:MR
First Name:PEDRO
Middle Name:R
Last Name:ARCIS
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4104 HOLLOWTRAIL DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-1225
Mailing Address - Country:US
Mailing Address - Phone:813-647-1897
Mailing Address - Fax:
Practice Address - Street 1:4104 HOLLOWTRAIL DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33624-1225
Practice Address - Country:US
Practice Address - Phone:813-647-1897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-23
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA59504225700000X
FLAPRN11013997363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist