Provider Demographics
NPI:1245297993
Name:HORSEMAN, MICHAEL A (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:HORSEMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4410 W NEWBERRY RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-5200
Mailing Address - Country:US
Mailing Address - Phone:352-372-7800
Mailing Address - Fax:352-372-7879
Practice Address - Street 1:4410 W NEWBERRY RD
Practice Address - Street 2:SUITE B
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-5200
Practice Address - Country:US
Practice Address - Phone:352-372-7800
Practice Address - Fax:352-372-7879
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME59220207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL370481599Medicaid
FL080096643OtherMEDICARE RAILROAD
FL6198218OtherCIGNA
FL219714OtherAVMED
FL15244OtherBLUE CROSS BLUE SHIELD
FL066441OtherVISTA HEALTHPLAN
FL066441OtherVISTA HEALTHPLAN
FL219714OtherAVMED