MEDICARE: DR. PASCAL EDWARD SPEHAR M.D.

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	208600000X	Surgery Physician	ME133800	FL
2	208600000X	Surgery Physician	105155	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	23583	OTHER	MO	BNDD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790738300
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PASCAL EDWARD SPEHAR M.D.

Provider Business Mailing Address
First Line	:	2995 DREW ST FL 2
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33759-3012
Country	:	US
Telephone Number	:	727-532-1355
Fax Number	:	813-635-2613

Provider Business Practice Location Address
First Line	:	1601 W TIMBERLANE DR STE 100
Second Line	:
City	:	PLANT CITY
State	:	FL
Zip	:	33566-0957
Country	:	US
Telephone Number	:	813-708-1312
Fax Number	:	813-443-8147

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

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	03/07/2023

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