Provider Demographics
NPI:1952321903
Name:ANCHETA, ARLEIGH I (DO)
Entity Type:Individual
Prefix:DR
First Name:ARLEIGH
Middle Name:I
Last Name:ANCHETA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8145 CEREBELLUM WAY
Mailing Address - Street 2:SUITE 101 & 102
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-1788
Mailing Address - Country:US
Mailing Address - Phone:727-845-4999
Mailing Address - Fax:866-777-2195
Practice Address - Street 1:8145 CEREBELLUM WAY
Practice Address - Street 2:SUITE 101 & 102
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-1788
Practice Address - Country:US
Practice Address - Phone:727-845-4999
Practice Address - Fax:866-777-2195
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0007816207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL138682343OtherGROUP NPI
FL260609255OtherGROUP TAX ID
FL001553500OtherGROUP MEDICAID
FL256093300Medicaid
FLBC538GOtherGROUP MEDICARE PIN
FL138682343OtherGROUP NPI
FLBC538GOtherGROUP MEDICARE PIN