Healthcare Provider Details

I. General information

NPI: 1053310003
Provider Name (Legal Business Name): RONALD P SPENCER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 02/14/2020
Certification Date: 02/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3231 SW 34TH AVE
OCALA FL
34474-8489
US

IV. Provider business mailing address

3231 SW 34TH AVE
OCALA FL
34474-8489
US

V. Phone/Fax

Practice location:
  • Phone: 352-873-7400
  • Fax: 352-873-7435
Mailing address:
  • Phone: 352-873-7400
  • Fax: 352-873-7435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberME43528
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207VH0002X
TaxonomyHospice and Palliative Medicine (Obstetrics & Gynecology) Physician
License NumberME43528
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number43528
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: