Provider Demographics
NPI:1851587794
Name:EMILY F ARSENAULT MD PA
Entity Type:Organization
Organization Name:EMILY F ARSENAULT MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:F
Authorized Official - Last Name:ARSENAULT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-907-0222
Mailing Address - Street 1:8926 77TH TER E
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202-6417
Mailing Address - Country:US
Mailing Address - Phone:941-907-0222
Mailing Address - Fax:941-907-0493
Practice Address - Street 1:8374 MARKET ST
Practice Address - Street 2:# 402
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34202-5137
Practice Address - Country:US
Practice Address - Phone:941-907-0222
Practice Address - Fax:941-907-0493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-24
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME87116207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE6155XOtherMEDICARE INDIVIDUAL #
FLP39591OtherUPIN
FL78732ZOtherMEDICARE INDIVIDUAL #
FLH61103OtherUPIN
FLK8767Medicare PIN