Provider Demographics
NPI:1861663700
Name:ARNOLD, BRUCE DUANE (RT)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:DUANE
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:RT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5750 FALL RIVER DR
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-1114
Mailing Address - Country:US
Mailing Address - Phone:727-375-9323
Mailing Address - Fax:727-376-7376
Practice Address - Street 1:5750 FALL RIVER DR
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-1114
Practice Address - Country:US
Practice Address - Phone:727-375-9323
Practice Address - Fax:727-376-7376
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCRT 52970247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist