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General NPI Number Information
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NPI Number | 1154786671
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Entity Type | Individual
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Provider Name | MARC SPIVEY M.S.
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Gender | Male
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Dates
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Enumeration Date | 12/28/2015
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Last Update Date | 12/28/2015
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Provider Practice Location Address
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Address Line | 8610 E COUNTY ROAD 466
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City | LADY LAKE
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State | FL
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Zip | 32162-3670
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Country | US
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Telephone | 352-391-5866
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Fax |
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Provider Business Mailing Address
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Address Line | 37032 GRAYS AIRPORT RD
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City | LADY LAKE
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State | FL
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Zip | 32159-5302
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Country | US
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Telephone | 352-267-2348
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT1633
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License Number State | FL
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