Individual provider Active NPI

Fidel Arbolaez, M.D.

  • Family Medicine Physician
  • Winter Haven, FL
National Provider Identifier
1750368973
Registry record updated Feb 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME57513 Issued in FL
Practice address
2090 Havendale Blvd NW
Winter Haven, FL 33881-3817
Phone
(863) 297-5801
Fax
(863) 297-5628
NPI assigned
Dec 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME57513 FL Primary

Addresses

Primary practice location

2090 Havendale Blvd NW
Winter Haven, FL 33881-3817

Mailing address

PO Box 616788
Orlando, FL 32861-6788
Phone (407) 447-7105

Other identifiers 1

IdentifierTypeStateIssuer
378930600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME57513FLMDFamily Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360281600000",
    "number": "1750368973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 616788",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328616788",
            "telephone_number": "407-447-7105",
            "fax_number": "407-770-0594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 HAVENDALE BLVD NW",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338813817",
            "telephone_number": "863-297-5801",
            "fax_number": "863-297-5628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARBOLAEZ",
        "first_name": "FIDEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2013-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME57513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "378930600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.