Basic Information
| Provider Information | |||||||||
| NPI: | 1225037146 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ARNOLD | ||||||||
| FirstName: | ANITA | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2147 | ||||||||
| Address2: | |||||||||
| City: | FORT MYERS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339022147 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2393436350 | ||||||||
| FaxNumber: | 2393436358 | ||||||||
| Practice Location | |||||||||
| Address1: | 9800 S. HEALTHPARK DRIVE | ||||||||
| Address2: | SUITE 320 | ||||||||
| City: | FORT MYERS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2393436350 | ||||||||
| FaxNumber: | 2393436358 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2005 | ||||||||
| LastUpdateDate: | 03/24/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 03/24/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | OS10519 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 30059400 | 05 | WI | MEDICAID | 51536941 | 01 | AL | BCBS | OTHER | 004560500 | 05 | FL | MEDICAID | 009940597 | 05 | AL | MEDICAID | 14JN6 | 01 | FL | BLUE CROSS BLUE SHIELD | OTHER |