Provider Demographics
NPI:1720338353
Name:ARTHUR A MAUCERI M.D. P.A.
Entity type:Organization
Organization Name:ARTHUR A MAUCERI M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:ANGELO
Authorized Official - Last Name:MAUCERI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-551-3650
Mailing Address - Street 1:6831 NW 11TH PL
Mailing Address - Street 2:SUITE 2
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4249
Mailing Address - Country:US
Mailing Address - Phone:352-331-3650
Mailing Address - Fax:352-331-6000
Practice Address - Street 1:6831 NW 11TH PL
Practice Address - Street 2:SUITE 2
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4249
Practice Address - Country:US
Practice Address - Phone:352-331-3650
Practice Address - Fax:352-331-6000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-11
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME12375207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL050232400Medicaid
FL111072699OtherRR MEDICARE
FL01173OtherBCBS FL
FL215651OtherAVMED
FL215651OtherAVMED