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NPI Code Detail

MEDICARE: DR. LOUISE RUTH SPIERRE M.D

MEDICARE:  DR. LOUISE RUTH SPIERRE  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
1208100000XPhysical Medicine & Rehabilitation PhysicianME96886FL
22081P0010XPediatric Rehabilitation Medicine PhysicianME96886FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00385496OTHERFLRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821030248
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LOUISE RUTH SPIERRE M.D
Provider Business Mailing Address
First Line : PO BOX 44008
Second Line : UFJP PEDIATRIC DEPARTMENT
City : JACKSONVILLE
State : FL
Zip : 32231-4008
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6271 ST. AUGUSTINE ROAD
Second Line : UFJP PEDIATRIC AND ADOLESCENT CENTER
City : JACKSONVILLE
State : FL
Zip : 32207
Country : US
Telephone Number : 904-633-0460
Fax Number : 904-633-0461
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2006
Last Update Date : 05/14/2009

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