Basic Information
| Provider Information | |||||||||
| NPI: | 1134133192 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AROCA | ||||||||
| FirstName: | ESTUARDO | ||||||||
| MiddleName: | E. | ||||||||
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| Credential: | D.O | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2675 WINKLER AVE FL 2 | ||||||||
| Address2: | |||||||||
| City: | FORT MYERS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339019342 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8778563774 | ||||||||
| FaxNumber: | 9415055501 | ||||||||
| Practice Location | |||||||||
| Address1: | 25086 OLYMPIA AVE UNIT 320 | ||||||||
| Address2: | |||||||||
| City: | PUNTA GORDA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339503932 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9415055500 | ||||||||
| FaxNumber: | 9415055501 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2006 | ||||||||
| LastUpdateDate: | 09/08/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | OS 9103 | FL | Y | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 2002-00489 | NC | N | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | OS9103 | 01 | FL | ME LICENSE | OTHER | 89134CJ | 05 | NC | MEDICAID | 003402300 | 05 | FL | MEDICAID | BA7544439 | 01 | FL | DEA CERTIFICATE | OTHER |