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General NPI Number Information
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NPI Number | 1174264600
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Entity Type | Organization
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Legal Business Name | PM SPENCER PSYCHIATRY LLC
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Dates
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Enumeration Date | 04/06/2022
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 1420 CELEBRATION BLVD STE 200
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City | CELEBRATION
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State | FL
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Zip | 34747-5162
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Country | US
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Telephone | 407-676-4276
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Fax | 888-684-2566
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Provider Business Mailing Address
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Address Line | 106 HIDDEN PALMS CT
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City | DAVENPORT
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State | FL
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Zip | 33897-8412
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Country | US
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Telephone | 810-406-8856
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Fax | 888-684-2566
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Authorized Official
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Title or Position | OWNER
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Name | MS. PRECIOUS MONIQUE SPENCER
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Credential | APRN, PMHNP-BC
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Telephone | 800-696-7024
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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