Provider Demographics
NPI:1972802817
Name:BACA-ARUS, ARTURO MANUEL (OPTICIAN)
Entity type:Individual
Prefix:
First Name:ARTURO
Middle Name:MANUEL
Last Name:BACA-ARUS
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8485 SW 40TH ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-3244
Mailing Address - Country:US
Mailing Address - Phone:305-223-6142
Mailing Address - Fax:305-552-0824
Practice Address - Street 1:8485 SW 40TH ST
Practice Address - Street 2:SUITE 103
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-3244
Practice Address - Country:US
Practice Address - Phone:305-223-6142
Practice Address - Fax:305-552-0824
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-17
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO6271156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician