Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | PO4062 | FL |
N | 222Z00000X | Podiatrist | PO4062 | FL |
N | 213EP0504X | Public Medicine | PO4062 | FL |
N | 213EP1101X | Primary Podiatric Medicine | PO4062 | FL |
N | 111NR0200X | Radiology | PO4062 | FL |
N | 213ER0200X | Radiology | PO4062 | FL |
N | 2081S0010X | Sports Medicine | PO4062 | FL |
N | 213ES0000X | Sports Medicine | PO4062 | FL |
Y | 213ES0103X | Foot & Ankle Surgery | PO4062 | FL |
N | 213ES0131X | Foot Surgery | PO4062 | FL |
NPI | 1770010423 |
---|---|
Provider Name | Dr. Jason C Spector |
First Address | Bradenton, FL 34202-3785 |
Second Address | Bradenton, FL 34202-3785 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2017 |
Last Update Date | 02/09/2021 |