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General NPI Number Information
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NPI Number | 1477690857
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Entity Type | Organization
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Legal Business Name | SPOLI INVESTMENTS INC
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 07/08/2008
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Provider Practice Location Address
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Address Line | 1157 JOHN ANDERSON DR
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City | ORMOND BEACH
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State | FL
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Zip | 32176-4173
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Country | US
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Telephone | 386-441-6049
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Fax | 386-247-4559
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Provider Business Mailing Address
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Address Line | 1157 JOHN ANDERSON DRIVE
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City | ORMOND BEACH
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State | FL
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Zip | 32176-4173
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Country | US
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Telephone | 386-441-6045
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Fax | 386-274-4557
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Authorized Official
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Title or Position | BOOKKEEPER
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Name | LAUREN K BAGGERSON
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Credential |
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Telephone | 386-258-8789
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 676245096
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License Number State | FL
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