Provider Demographics
NPI:1225100423
Name:SEMEL, ARNOLD M (OD)
Entity Type:Individual
Prefix:
First Name:ARNOLD
Middle Name:M
Last Name:SEMEL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1732 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-3602
Mailing Address - Country:US
Mailing Address - Phone:954-432-7711
Mailing Address - Fax:954-432-8017
Practice Address - Street 1:1732 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-3602
Practice Address - Country:US
Practice Address - Phone:954-432-7711
Practice Address - Fax:954-432-8017
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC1501152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3645OtherDAVIS VISION
FL19748OtherBLUE CROSS BLUE SHIELD
FL154OtherOPTIX FRINGE
FL057OtherFOPN
FL19748OtherBLUE CROSS BLUE SHIELD
FL19748YMedicare ID - Type UnspecifiedMEDICARE