Provider Demographics
NPI:1366406563
Name:ARISON, RON (MD)
Entity type:Individual
Prefix:
First Name:RON
Middle Name:
Last Name:ARISON
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 1:2438 E COMMERCIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4040
Mailing Address - Country:US
Mailing Address - Phone:954-772-6740
Mailing Address - Fax:954-772-6703
Practice Address - Street 1:2438 E COMMERCIAL BLVD
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4040
Practice Address - Country:US
Practice Address - Phone:954-772-6740
Practice Address - Fax:954-772-6703
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-14
Last Update Date:2010-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0042608208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL045099500Medicaid
FL222339OtherAVMED
FL94179OtherBLUE CROSS BLUE SHIELD
FLP00059222OtherRAILROAD MEDICARE
FL222339OtherAVMED
FL94179OtherBLUE CROSS BLUE SHIELD