MEDICARE: GERALD L. SPOTO, D.D.S., P.A.

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
1	1223G0001X	General Practice Dentistry	5341	FL

General Provider Information

NPI Number	:	1598985988
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GERALD L. SPOTO, D.D.S., P.A.

Provider Business Mailing Address
First Line	:	5420 WEBB ROAD
Second Line	:	SUITE A-2
City	:	TAMPA
State	:	FL
Zip	:	33615-3255
Country	:	US
Telephone Number	:	813-884-3287
Fax Number	:	813-884-6977

Provider Business Practice Location Address
First Line	:	5420 WEBB RD
Second Line	:	SUITE A-2
City	:	TAMPA
State	:	FL
Zip	:	33615-3250
Country	:	US
Telephone Number	:	813-884-3287
Fax Number	:	813-884-6977

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. GERALD L. SPOTO
Credential	:	D.D.S.
Telephone Number	:	813-884-3287

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	08/22/2020

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