Provider Demographics
NPI:1518084573
Name:VISCONTI, MICHAEL ARTHUR (LAC, ND)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ARTHUR
Last Name:VISCONTI
Suffix:
Gender:M
Credentials:LAC, ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1204
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:34760-1204
Mailing Address - Country:US
Mailing Address - Phone:407-614-1616
Mailing Address - Fax:407-614-1617
Practice Address - Street 1:301 S TUBB ST STE E-2
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:FL
Practice Address - Zip Code:34760-8859
Practice Address - Country:US
Practice Address - Phone:407-614-1616
Practice Address - Fax:407-614-1617
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT099-0000178175F00000X
FLAP 1839171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No175F00000XOther Service ProvidersNaturopath