Provider Demographics
NPI:1730286337
Name:ARLENE E HAYWOOD, M.D., PA
Entity Type:Organization
Organization Name:ARLENE E HAYWOOD, M.D., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARLENE
Authorized Official - Middle Name:E
Authorized Official - Last Name:HAYWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-583-3500
Mailing Address - Street 1:6971 W SUNRISE BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33313-4407
Mailing Address - Country:US
Mailing Address - Phone:954-583-3500
Mailing Address - Fax:954-583-3512
Practice Address - Street 1:6971 W SUNRISE BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33313-4407
Practice Address - Country:US
Practice Address - Phone:954-583-3500
Practice Address - Fax:954-583-3512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-18
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL036671208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL379116500Medicaid