MEDICARE: ACSA SPIELVOGEL APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	11035843	FL

General Provider Information

NPI Number	:	1427873025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ACSA SPIELVOGEL APRN

Provider Business Mailing Address
First Line	:	1512 SW 191ST TER
Second Line	:
City	:	PEMBROKE PINES
State	:	FL
Zip	:	33029-6162
Country	:	US
Telephone Number	:	832-454-6338
Fax Number	:

Provider Business Practice Location Address
First Line	:	6950 CYPRESS RD STE 107
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33317-2361
Country	:	US
Telephone Number	:	754-202-1000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2024
Last Update Date	:	12/04/2024

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