Healthcare Provider Details

I. General information

NPI: 1477342012
Provider Name (Legal Business Name): VANGUARD SPINE AND PAIN PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2025
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 GOODLETTE-FRANK RD N STE 204
NAPLES FL
34102-5656
US

IV. Provider business mailing address

720 GOODLETTE-FRANK RD N STE 204
NAPLES FL
34102-5656
US

V. Phone/Fax

Practice location:
  • Phone: 239-387-2305
  • Fax: 239-387-2305
Mailing address:
  • Phone: 239-387-2305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CONOR SPERZEL
Title or Position: PRESIDENT
Credential: MD
Phone: 201-681-5338