Healthcare Provider Details

I. General information

NPI: 1255775003
Provider Name (Legal Business Name): MICHAEL SCOTT SPERTUS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2013
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 N BAYSHORE DR STE 1A-211
MIAMI FL
33132-3001
US

IV. Provider business mailing address

1900 N BAYSHORE DR STE 1A-211
MIAMI FL
33132-3001
US

V. Phone/Fax

Practice location:
  • Phone: 305-981-6871
  • Fax:
Mailing address:
  • Phone: 305-981-6871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number280658
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number28615
License Number StateNH
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number280658
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number162919
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number284639
License Number StateNY
# 6
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME158092
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: