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General NPI Number Information
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NPI Number | 1922455476
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Entity Type | Organization
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Legal Business Name | DR. SANDRA J SPENDER P.A.
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Dates
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Enumeration Date | 05/14/2016
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Last Update Date | 05/14/2016
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Provider Practice Location Address
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Address Line | 3250 NORTHLAKE BLVD
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33403-1702
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Country | US
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Telephone | 561-622-9985
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Fax |
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Provider Business Mailing Address
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Address Line | 204 WALTON HEATH DR
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City | ATLANTIS
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State | FL
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Zip | 33462-1128
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Country | US
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Telephone | 561-310-2480
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SANDRA JOANNE SPENDER
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Credential | O.D.
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Telephone | 561-310-2480
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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 | OPC2962
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License Number State | FL
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