Provider Demographics
NPI:1427185628
Name:VICTOR ARBOLEDA MD PA
Entity Type:Organization
Organization Name:VICTOR ARBOLEDA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:ARBOLEDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-442-6068
Mailing Address - Street 1:525 S HERCULES AVE
Mailing Address - Street 2:STE 102
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764-6320
Mailing Address - Country:US
Mailing Address - Phone:727-442-6068
Mailing Address - Fax:727-443-4894
Practice Address - Street 1:525 S HERCULES AVE
Practice Address - Street 2:STE 102
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-6313
Practice Address - Country:US
Practice Address - Phone:727-442-6068
Practice Address - Fax:727-443-4894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME67231207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
F73546Medicare UPIN
AC375Medicare ID - Type UnspecifiedPTAN