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NPI Code Detail

MEDICARE: SMARO YANNOULA SPANDONIDIS

MEDICARE:   SMARO YANNOULA SPANDONIDIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramMN

General Provider Information

NPI Number : 1306779392
Entity Type Code : Individual
Provider Name (Legal Business Name) : SMARO YANNOULA SPANDONIDIS
Provider Business Mailing Address
First Line : 1216 2ND ST SW
Second Line :
City : ROCHESTER
State : MN
Zip : 55902-1906
Country : US
Telephone Number : 815-272-3184
Fax Number :
Provider Business Practice Location Address
First Line : 1216 2ND ST SW
Second Line :
City : ROCHESTER
State : MN
Zip : 55902-1906
Country : US
Telephone Number : 815-272-3184
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2026
Last Update Date : 06/08/2026

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Directions to “ SMARO YANNOULA SPANDONIDIS ” Practice Location

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