Healthcare Provider Details

I. General information

NPI: 1306877147
Provider Name (Legal Business Name): LINDO TERRY SPENCER JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: LINDO T SPENCER JR. MD

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

593 EDDY ST
PROVIDENCE RI
02903-4923
US

IV. Provider business mailing address

PO BOX 1137
MELBOURNE FL
32902-1137
US

V. Phone/Fax

Practice location:
  • Phone: 401-444-6540
  • Fax: 401-444-6543
Mailing address:
  • Phone: 321-952-9696
  • Fax: 321-952-7937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD17247
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME129576
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License NumberME129576
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: