Provider Demographics
NPI:1699974865
Name:ARLEIGH I ANCHETA D O P A
Entity type:Organization
Organization Name:ARLEIGH I ANCHETA D O P A
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARLEIGH
Authorized Official - Middle Name:I
Authorized Official - Last Name:ANCHETA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:727-845-4999
Mailing Address - Street 1:2595 TAMPA RD STE G
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-3130
Mailing Address - Country:US
Mailing Address - Phone:727-845-4999
Mailing Address - Fax:727-771-6979
Practice Address - Street 1:2595 TAMPA RD STE G
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-3130
Practice Address - Country:US
Practice Address - Phone:727-845-4999
Practice Address - Fax:727-771-6979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-17
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0007816207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL067804000Medicaid
FL265820800Medicaid
FL1952321903OtherNPI
FL256093300Medicaid
FL265820801Medicaid
FL067804000Medicaid
FL067804000Medicaid
FLD57455Medicare UPIN
FL265820800Medicaid
FL265820801Medicaid
FL256093300Medicaid