Healthcare Provider Details

I. General information

NPI: 1841100906
Provider Name (Legal Business Name): PHILIP AUSTIN SPENCER HCP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1616 CAPE CORAL PKWY W STE 116
CAPE CORAL FL
33914-6973
US

IV. Provider business mailing address

4540 SW 12TH PL
CAPE CORAL FL
33914-6323
US

V. Phone/Fax

Practice location:
  • Phone: 239-772-8189
  • Fax:
Mailing address:
  • Phone: 239-772-8189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberAST-1529
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: