Provider Demographics
NPI:1447205281
Name:ARESERY, MATTHEW J (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:J
Last Name:ARESERY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11505 RANGELAND PKWY
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34211-4041
Mailing Address - Country:US
Mailing Address - Phone:941-362-8640
Mailing Address - Fax:941-362-8641
Practice Address - Street 1:11505 RANGELAND PKWY
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34211-4041
Practice Address - Country:US
Practice Address - Phone:941-362-8640
Practice Address - Fax:941-362-8641
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME016496207K00000X
FLME111116207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14L3AOtherFL BC/BS
FL005930700Medicaid
H61143Medicare UPIN
FLGF587YMedicare PIN