Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | PO2393 | FL |
N | 222Z00000X | Podiatrist | PO2393 | FL |
Y | 213ES0103X | Foot & Ankle Surgery | PO2393 | FL |
N | 213ES0131X | Foot Surgery | PO2393 | FL |
NPI | 1366556136 |
---|---|
Provider Name | Ira Spinner |
First Address | Boynton Beach, FL 33437-3535 |
Second Address | Boynton Beach, FL 33437-3536 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2006 |
Last Update Date | 17/11/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
390148300 | (05) | FL |
65312 | BLUE CROSS BLUE SHIELD (01) | FL |
U35922 | (02) |