Healthcare Provider Details
I. General information
NPI: 1982984381
Provider Name (Legal Business Name): STEPHANIE C SPINELLI & ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/17/2011
Last Update Date: 02/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
22 LAKE BEAUTY DR
ORLANDO FL
32806-2037
US
IV. Provider business mailing address
22 LAKE BEAUTY DR
ORLANDO FL
32806-2037
US
V. Phone/Fax
- Phone: 407-896-1152
- Fax:
- Phone: 407-896-1152
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
KASEY
LYNN
GREBOSZ
Title or Position: OCCUPATIONAL THERAPY ASSISTANT
Credential:
Phone: 386-848-2749