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General NPI Number Information
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NPI Number | 1750267233
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Entity Type | Individual
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Provider Name | SPENCER HAIRE
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Gender | Male
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Dates
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Enumeration Date | 08/12/2025
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 16939 SW 134TH AVE
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City | ARCHER
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State | FL
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Zip | 32618-5413
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Country | US
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Telephone | 352-265-2550
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Fax |
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Provider Business Mailing Address
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Address Line | 12746 NW 173RD LN
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City | ALACHUA
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State | FL
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Zip | 32615-4468
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Country | US
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Telephone | 352-538-6559
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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 | 11041957
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN11041957
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License Number State | FL
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