Provider Demographics
NPI:1205139185
Name:DIABETES1ON1
Entity type:Organization
Organization Name:DIABETES1ON1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:LAZARO
Authorized Official - Last Name:ARCE
Authorized Official - Suffix:JR
Authorized Official - Credentials:RN, CDE, CPT
Authorized Official - Phone:305-733-2929
Mailing Address - Street 1:1548 SW 189TH TER
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-6143
Mailing Address - Country:US
Mailing Address - Phone:305-733-2929
Mailing Address - Fax:954-367-6789
Practice Address - Street 1:1548 SW 189TH TER
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33029-6143
Practice Address - Country:US
Practice Address - Phone:305-733-2929
Practice Address - Fax:954-367-6789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-14
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2011-0004174H00000X
FLRN3367672163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes EducatorGroup - Single Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty