Provider Demographics
NPI:1528071289
Name:ARNOLETTI, JUAN PABLO (MD)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:PABLO
Last Name:ARNOLETTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2501 N ORANGE AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-4641
Mailing Address - Country:US
Mailing Address - Phone:407-821-3620
Mailing Address - Fax:407-821-3621
Practice Address - Street 1:2501 N ORANGE AVE STE 201
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-4641
Practice Address - Country:US
Practice Address - Phone:407-821-3620
Practice Address - Fax:407-821-3621
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL247322086X0206X
FLME1132512086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009901205Medicaid
AL020053349OtherRR MEDICARE
AL051510935OtherBCBS OF AL
AL051552067Medicaid
AL051510936OtherBCBS OF AL
AL020053349OtherRR MEDICARE