Provider Demographics
NPI:1154651024
Name:MIKE ARSOV MD PA
Entity Type:Organization
Organization Name:MIKE ARSOV MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:ARSOV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-933-0900
Mailing Address - Street 1:908 W MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4117
Mailing Address - Country:US
Mailing Address - Phone:407-933-0900
Mailing Address - Fax:407-933-4774
Practice Address - Street 1:908 W MAGNOLIA ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4117
Practice Address - Country:US
Practice Address - Phone:407-933-0900
Practice Address - Fax:407-933-4774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-28
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0066144261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL376829500Medicaid
FL25545OtherBC/BS
FL25545OtherBC/BS
FLF54923Medicare UPIN