Provider Demographics
NPI:1982815940
Name:DAX ARHTIRIS CLINIC, INC
Entity Type:Organization
Organization Name:DAX ARHTIRIS CLINIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ANDREA
Authorized Official - Last Name:SAITTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-642-8488
Mailing Address - Street 1:1010 N BARFIELD DR
Mailing Address - Street 2:
Mailing Address - City:MARCO ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:34145-2353
Mailing Address - Country:US
Mailing Address - Phone:239-642-8488
Mailing Address - Fax:239-642-6979
Practice Address - Street 1:1010 N BARFIELD DR
Practice Address - Street 2:
Practice Address - City:MARCO ISLAND
Practice Address - State:FL
Practice Address - Zip Code:34145-2353
Practice Address - Country:US
Practice Address - Phone:239-642-8488
Practice Address - Fax:239-642-6979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME48065174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLEI016AMedicare PIN