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1218 N Broadway Ave Bartow FL 33830-3343 | |
| (863) 533-6528 | |
| (863) 534-3641 |
| Full Name | |
|---|---|
| Speciality | Clinic/center |
| Location | 1218 N Broadway Ave, Bartow, Florida |
| Authorized Official Name and Position | Ricardo Arguello (OWNER) |
| Authorized Official Contact | 8635336528 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1218 N Broadway Ave Bartow FL 33830-3343 Ph: (863) 533-6528 | 1218 N Broadway Ave Bartow FL 33830-3343 Ph: (863) 533-6528 |
| NPI Number | 1861875122 |
|---|---|
| Provider Enumeration Date | 07/06/2015 |
| Last Update Date | 07/06/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861875122 | NPI | - | NPPES |
| 006K0 | Other | FL | BC/BS |
| 061451300 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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