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General NPI Number Information
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NPI Number | 1063844678
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Entity Type | Individual
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Provider Name | TERESA SPANO ND, CNS
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Gender | Female
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Dates
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Enumeration Date | 08/06/2013
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Last Update Date | 02/16/2024
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Provider Practice Location Address
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Address Line | 1570 COLONIAL BLVD STE A
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City | FORT MYERS
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State | FL
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Zip | 33907-1031
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Country | US
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Telephone | 239-766-7311
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Fax |
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Provider Business Mailing Address
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Address Line | 18 SCHOOL ST
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City | GLASTONBURY
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State | CT
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Zip | 06033-2241
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | ND8843
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | 500
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License Number State | CT
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