Healthcare Provider Details

I. General information

NPI: 1003869686
Provider Name (Legal Business Name): LORI A. SPOOR DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 09/26/2023
Certification Date: 09/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 COLUMBIA RD NW
WASHINGTON DC
20009-2803
US

IV. Provider business mailing address

2501 W. KENNEDY BVLD.
TAMPA FL
33609-2501
US

V. Phone/Fax

Practice location:
  • Phone: 202-469-4699
  • Fax: 813-254-0230
Mailing address:
  • Phone: 813-844-1385
  • Fax: 813-254-0230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS9996
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO210001812
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: