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General NPI Number Information
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NPI Number | 1558689943
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Entity Type | Organization
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Legal Business Name | SPEARS & SPEARS GENERAL CONTRACTING, INC.
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Dates
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Enumeration Date | 05/10/2010
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Last Update Date | 05/10/2010
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Provider Practice Location Address
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Address Line | 2605 KURT ST STE A
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City | EUSTIS
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State | FL
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Zip | 32726-8201
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Country | US
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Telephone | 352-357-6588
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Fax | 352-357-6590
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Provider Business Mailing Address
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Address Line | 2605 KURT ST STE A
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City | EUSTIS
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State | FL
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Zip | 32726-8201
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Country | US
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Telephone | 352-357-6588
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Fax | 352-357-6590
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Authorized Official
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Title or Position | CEO
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Name | MR. KEITH ALLEN SPEARS
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Credential |
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Telephone | 352-357-6588
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171WH0202X
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Taxonomy Name | Home Modifications Contractor
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License Number | CG-C057665
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License Number State | FL
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