Healthcare Provider Details

I. General information

NPI: 1942441498
Provider Name (Legal Business Name): MICHAIL SPILIOPOULOS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2009
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 SE 3RD AVE STE 415
FORT LAUDERDALE FL
33316-2521
US

IV. Provider business mailing address

1608 SE 3RD AVE FL 3
FORT LAUDERDALE FL
33316-2564
US

V. Phone/Fax

Practice location:
  • Phone: 954-958-9959
  • Fax: 855-855-2793
Mailing address:
  • Phone: 954-958-9959
  • Fax: 855-855-2793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME145831
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberME145831
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: