Provider Demographics
NPI:1669408365
Name:LAIRD, MICHAEL E (ARNP)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:E
Last Name:LAIRD
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14690 SPRING HILL DR
Mailing Address - Street 2:STE 305
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-8102
Mailing Address - Country:US
Mailing Address - Phone:352-277-5348
Mailing Address - Fax:352-606-2857
Practice Address - Street 1:3480 DELTONA BLVD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-2917
Practice Address - Country:US
Practice Address - Phone:352-600-7900
Practice Address - Fax:352-600-8994
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP3052402363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00819183OtherRR MEDICARE
FL307839600Medicaid
P97875Medicare UPIN
U1317XMedicare PIN