Healthcare Provider Details

I. General information

NPI: 1013919042
Provider Name (Legal Business Name): JAMES ROBERT SPENCER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 02/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 WEBBER ST
SARASOTA FL
34239-5288
US

IV. Provider business mailing address

2001 WEBBER ST
SARASOTA FL
34239-5288
US

V. Phone/Fax

Practice location:
  • Phone: 941-362-8900
  • Fax: 941-362-8987
Mailing address:
  • Phone: 941-362-8900
  • Fax: 941-362-8987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZC0006X
TaxonomyClinical Pathology Physician
License NumberME15499
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: