Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DN16241 | FL |
NPI | 1043408354 |
---|---|
Provider Name | Dr. Frank John Spino |
First Address | Sarasota, FL 34236-7102 |
Second Address | Sarasota, FL 34236-7102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2007 |
Last Update Date | 11/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DN16241 | LICENSE NUMBER (01) |