Provider Demographics
NPI:1558544247
Name:ARSENAULT, MICHAEL J (LMT)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:J
Last Name:ARSENAULT
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14120 NE 31ST DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32609-8877
Mailing Address - Country:US
Mailing Address - Phone:352-485-3569
Mailing Address - Fax:
Practice Address - Street 1:418 W CALL ST
Practice Address - Street 2:
Practice Address - City:STARKE
Practice Address - State:FL
Practice Address - Zip Code:32091-3116
Practice Address - Country:US
Practice Address - Phone:352-281-7217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-17
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA39030225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC-2378OtherBLUECROSS/BLUESHEILD FL.