MEDICARE: CARL SPIRAZZA D.O.

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	207Q00000X	Family Medicine Physician	OS0005160	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00439656	OTHER	FL	RAILROAD MEDICARE
3	33803A	OTHER	FL	MEDICARE GROUP PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	230482	OTHER	FL	AMERIGROUP
4	80005	OTHER	FL	BLUE CROSS BLUE SHIELD OF FLA
5	205522	OTHER	FL	AVMED
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881784833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARL SPIRAZZA D.O.

Provider Business Mailing Address
First Line	:	10151 ENTERPRISE CTR BLVD
Second Line	:	SUITE 106
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-3760
Country	:	US
Telephone Number	:	561-734-7400
Fax Number	:	561-734-7448

Provider Business Practice Location Address
First Line	:	10151 ENTERPRISE CTR BLVD
Second Line	:	SUITE 106
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-3760
Country	:	US
Telephone Number	:	561-734-7400
Fax Number	:	561-734-7448

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

Provider Enumeration Date	:	10/13/2006
Last Update Date	:	02/04/2016

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Directions to “ CARL SPIRAZZA D.O.” Practice Location

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