Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | ME82838 | FL |
NPI | 1053313387 |
---|---|
Provider Name | Dr. Brian Spector |
First Address | Winter Park, FL 32792-4143 |
Second Address | Winter Park, FL 32792-4143 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2005 |
Last Update Date | 27/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01112087 | AMERIGROUP (01) | |
01905 | BLUE CROSS (01) | |
040016274 | RR MEDICARE (01) | |
040016275 | RR MEDICARE (01) | |
040016276 | RR MEDICARE (01) | |
262849000 | (05) | FL |
H43304 | (02) | |
ME82838 | WORKER'S COMP (01) |