Provider Demographics
NPI:1801137625
Name:ARSENAULT, TRAVIS
Entity type:Individual
Prefix:MR
First Name:TRAVIS
Middle Name:
Last Name:ARSENAULT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 SHUMAN BLVD
Mailing Address - Street 2:401
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8458
Mailing Address - Country:US
Mailing Address - Phone:352-243-1212
Mailing Address - Fax:
Practice Address - Street 1:235 CITRUS TOWER BLVD
Practice Address - Street 2:106
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-2712
Practice Address - Country:US
Practice Address - Phone:352-243-1212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-04
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS4736237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist