Provider Demographics
NPI:1891164059
Name:ARWAS, RAPHAEL
Entity Type:Individual
Prefix:DR
First Name:RAPHAEL
Middle Name:
Last Name:ARWAS
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:RAPHAEL
Other - Middle Name:
Other - Last Name:ARWAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1440 E. HALLANDALE BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33009
Mailing Address - Country:US
Mailing Address - Phone:954-458-1133
Mailing Address - Fax:954-458-5696
Practice Address - Street 1:1440 E. HALLANDALE BEACH BLVD
Practice Address - Street 2:
Practice Address - City:HALLANDALE
Practice Address - State:FL
Practice Address - Zip Code:33009
Practice Address - Country:US
Practice Address - Phone:954-458-1133
Practice Address - Fax:954-458-5696
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-17
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN130031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1669613436OtherPPO