Healthcare Provider Details

I. General information

NPI: 1205820743
Provider Name (Legal Business Name): BETHEL SUSAN STEINDEL-SPARGO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BETHEL STEINDEL-KOPP MD

II. Dates (important events)

Enumeration Date: 09/09/2005
Last Update Date: 05/04/2023
Certification Date: 05/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1951 SW 172ND AVE STE 204
MIRAMAR FL
33029-5613
US

IV. Provider business mailing address

2900 CORPORATE WAY DOOR D
MIRAMAR FL
33025-3925
US

V. Phone/Fax

Practice location:
  • Phone: 954-538-4621
  • Fax: 954-538-4629
Mailing address:
  • Phone: 954-276-5685
  • Fax: 954-985-7074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License NumberME76772
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: