Provider Demographics
NPI:1497719710
Name:RON ARISON MD PL LLC
Entity Type:Organization
Organization Name:RON ARISON MD PL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:ARISON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-772-6740
Mailing Address - Street 1:2438 E COMMERCIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4040
Mailing Address - Country:US
Mailing Address - Phone:954-772-6740
Mailing Address - Fax:954-772-6703
Practice Address - Street 1:2438 E COMMERCIAL BLVD
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4040
Practice Address - Country:US
Practice Address - Phone:954-772-6740
Practice Address - Fax:954-772-6703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-13
Last Update Date:2013-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME42608208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDA4470OtherRAILROAD MEDICARE
FL34799OtherBLUE CROSS/BLUE SHIELD
FL267416500Medicaid
FLK4441Medicare PIN