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General NPI Number Information
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NPI Number | 1447910062
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Entity Type | Individual
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Provider Name | RONDA SPILLIARD FNP-C
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Gender | Female
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Dates
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Enumeration Date | 12/22/2021
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Last Update Date | 12/22/2021
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Provider Practice Location Address
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Address Line | 3631 W BURLEIGH BLVD
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City | TAVARES
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State | FL
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Zip | 32778-5803
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Country | US
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Telephone | 352-742-0025
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Fax | 352-742-8167
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Provider Business Mailing Address
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Address Line | 313 WATER SHORE DR
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City | LEESBURG
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State | FL
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Zip | 34748-7009
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Country | US
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Telephone | 352-551-7317
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11017103
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License Number State | FL
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