Healthcare Provider Details

I. General information

NPI: 1467291153
Provider Name (Legal Business Name): SPT CONSULTING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2024
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14100 FIVAY RD STE 100
HUDSON FL
34667-7159
US

IV. Provider business mailing address

13046 RACE TRACK RD # 212
TAMPA FL
33626-1302
US

V. Phone/Fax

Practice location:
  • Phone: 727-819-2534
  • Fax:
Mailing address:
  • Phone: 813-766-8753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. SHAIVAL PRADIP THAKORE
Title or Position: MANAGER
Credential: MD
Phone: 813-766-8753