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General NPI Number Information
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NPI Number | 1912960022
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Entity Type | Individual
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Provider Name | MICHAEL F SPENCER OD
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Gender | Male
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Dates
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Enumeration Date | 04/10/2006
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Last Update Date | 08/05/2024
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Provider Practice Location Address
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Address Line | 3507 LEE BLVD STE 104
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City | LEHIGH ACRES
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State | FL
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Zip | 33971-1303
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Country | US
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Telephone | 239-369-5884
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Fax | 239-369-7320
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Provider Business Mailing Address
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Address Line | PO BOX 162264
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32716-2264
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Country | US
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Telephone | 941-792-2020
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Fax | 239-939-1575
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC3452
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License Number State | FL
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