MEDICARE: MISS MAGGY LESPINASSE 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
1	208000000X	Pediatrics Physician	MD08253	RI
2	208000000X	Pediatrics Physician	MD20826	ME
3	208000000X	Pediatrics Physician	ME164169	FL

General Provider Information

NPI Number	:	1699768291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS MAGGY LESPINASSE MD

Provider Business Mailing Address
First Line	:	5827 CORPORATE WAY
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-2000
Country	:	US
Telephone Number	:	561-844-9443
Fax Number	:	561-472-9692

Provider Business Practice Location Address
First Line	:	9576 S US HIGHWAY 1
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34952-4217
Country	:	US
Telephone Number	:	772-337-4000
Fax Number	:	844-543-0396

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2005
Last Update Date	:	06/25/2024

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