Provider Demographics
NPI:1205804713
Name:ARBOLEDA, VICTOR (MD)
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:ARBOLEDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 S HERCULES AVE
Mailing Address - Street 2:STE 102
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764-6313
Mailing Address - Country:US
Mailing Address - Phone:727-442-6068
Mailing Address - Fax:727-443-4894
Practice Address - Street 1:525 S HERCULES AVE
Practice Address - Street 2:STE 102
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-6313
Practice Address - Country:US
Practice Address - Phone:727-442-6068
Practice Address - Fax:727-443-4894
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME67231207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
26416VMedicare ID - Type UnspecifiedPTAN
F73546Medicare UPIN