Healthcare Provider Details

I. General information

NPI: 1154129658
Provider Name (Legal Business Name): STEVEN TROY SPILLER FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2025
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5068 ANNUNCIATION CIR UNIT 111
AVE MARIA FL
34142-9668
US

IV. Provider business mailing address

5036 SALERNO ST
AVE MARIA FL
34142-9578
US

V. Phone/Fax

Practice location:
  • Phone: 239-867-4395
  • Fax:
Mailing address:
  • Phone: 561-502-8146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN11038472
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11038472
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: