Healthcare Provider Details

I. General information

NPI: 1194354282
Provider Name (Legal Business Name): JULIANNE CARROLL SPIROS DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIANNE CARROLL PIZZOLATO

II. Dates (important events)

Enumeration Date: 04/02/2020
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11215 METRO PKWY STE 1
FORT MYERS FL
33966-1206
US

IV. Provider business mailing address

231 S BEMISTON AVE
SAINT LOUIS MO
63105-1988
US

V. Phone/Fax

Practice location:
  • Phone: 239-208-2212
  • Fax: 239-208-3994
Mailing address:
  • Phone: 314-255-8055
  • Fax: 636-590-1531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberUO7011
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2024026579
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: