1093953606 NPI number — MRS. ARMANDA ODETTE SPANGLER PTA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093953606 NPI number — MRS. ARMANDA ODETTE SPANGLER PTA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SPANGLER
Provider First Name:
ARMANDA
Provider Middle Name:
ODETTE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PTA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SPANGLER
Provider Other First Name:
ARMANDA
Provider Other Middle Name:
ODETTE
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PTA
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1093953606
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/22/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4325 NE 2ND CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OCALA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34479-1978
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
352-732-6773
Provider Business Mailing Address Fax Number:
888-758-9645

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
303 SE 17TH ST
Provider Second Line Business Practice Location Address:
#309-217
Provider Business Practice Location Address City Name:
OCALA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34471-4421
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-693-3378
Provider Business Practice Location Address Fax Number:
888-758-9645
Provider Enumeration Date:
02/04/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225200000X , with the licence number:  PTA21571 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 106898 . This is a "MEDICARE ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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