Provider Demographics
NPI:1144260605
Name:ARCA, NICANOR CHRISTOPHER (MD)
Entity type:Individual
Prefix:
First Name:NICANOR
Middle Name:CHRISTOPHER
Last Name:ARCA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 783427
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34778-3427
Mailing Address - Country:US
Mailing Address - Phone:407-575-0496
Mailing Address - Fax:
Practice Address - Street 1:300 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-3544
Practice Address - Country:US
Practice Address - Phone:407-233-1844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2012-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92331207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU5288WMedicare PIN