Provider Demographics
NPI:1437334133
Name:BACA-ARUS, ARTURO T (OPTICIAN)
Entity Type:Individual
Prefix:
First Name:ARTURO
Middle Name:T
Last Name:BACA-ARUS
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2821 SW 108TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-2445
Mailing Address - Country:US
Mailing Address - Phone:305-225-2006
Mailing Address - Fax:305-225-2006
Practice Address - Street 1:2750 W 68TH ST STE 115
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5448
Practice Address - Country:US
Practice Address - Phone:305-819-3937
Practice Address - Fax:305-819-0816
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-01
Last Update Date:2008-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO5877156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician