Provider Demographics
NPI:1821139189
Name:DE ARRIGOITIA, JORGE L (AP,DIPLAC)
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:L
Last Name:DE ARRIGOITIA
Suffix:
Gender:M
Credentials:AP,DIPLAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 MAGIC CT
Mailing Address - Street 2:SUITE 187
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-4526
Mailing Address - Country:US
Mailing Address - Phone:407-774-9355
Mailing Address - Fax:407-862-9355
Practice Address - Street 1:280 WEKIVA SPRINGS RD
Practice Address - Street 2:SUITE 1040
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32779-5946
Practice Address - Country:US
Practice Address - Phone:407-774-9355
Practice Address - Fax:407-862-9355
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 1478171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAP 1478OtherSTATE LICENSE
FL1029969OtherAMERICAN SPECIALITY HEALT