Healthcare Provider Details

I. General information

NPI: 1972567394
Provider Name (Legal Business Name): MICHAEL A BLANCHETTE ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 S TAMIAMI TRL
SARASOTA FL
34239-3509
US

IV. Provider business mailing address

1700 S TAMIAMI TRL
SARASOTA FL
34239-3509
US

V. Phone/Fax

Practice location:
  • Phone: 941-917-7867
  • Fax: 941-917-7193
Mailing address:
  • Phone: 941-917-7867
  • Fax: 941-917-7193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP1760192
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: