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NPI Code Detail

MEDICARE: ANNA SPORYSHEVA MD

MEDICARE: ANNA SPORYSHEVA MD
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
1207W00000XOphthalmology PhysicianME177477FL
2207WX0107XRetina Specialist (Ophthalmology) PhysicianME177477FL
3207W00000XOphthalmology Physician036.166561IL

General Provider Information

NPI Number : 1629691605
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNA SPORYSHEVA MD
Provider Business Mailing Address
First Line : 5 W SAMPLE RD
Second Line :
City : DEERFIELD BEACH
State : FL
Zip : 33064-3542
Country : US
Telephone Number : 954-782-1700
Fax Number : 954-782-0145
Provider Business Practice Location Address
First Line : 5 W SAMPLE RD
Second Line :
City : DEERFIELD BEACH
State : FL
Zip : 33064-3542
Country : US
Telephone Number : 954-782-1700
Fax Number : 954-782-0145
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2020
Last Update Date : 11/14/2025

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