Healthcare Provider Details

I. General information

NPI: 1235118167
Provider Name (Legal Business Name): MICHAEL ALAN ARNHOLTZ PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 05/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2760 SHERWOOD DR
NAVARRE FL
32566
US

IV. Provider business mailing address

2760 SHERWOOD DR
NAVARRE FL
32566
US

V. Phone/Fax

Practice location:
  • Phone: 850-217-3241
  • Fax: 850-936-7939
Mailing address:
  • Phone: 850-217-3241
  • Fax: 850-936-7939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA9105444
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: