Provider Demographics
NPI:1255999827
Name:ARCEBIDO, ALEC MIGUEL
Entity type:Individual
Prefix:
First Name:ALEC
Middle Name:MIGUEL
Last Name:ARCEBIDO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6559 CHERRY GROVE CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809-6656
Mailing Address - Country:US
Mailing Address - Phone:321-332-8772
Mailing Address - Fax:
Practice Address - Street 1:6559 CHERRY GROVE CIR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-6656
Practice Address - Country:US
Practice Address - Phone:321-332-8772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-30
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL585433336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy