1891768214 NPI number — HOWARD SCOTT SPINOWITZ DO

Table of content: YUKI FUJIMURA ANP (NPI 1306972385)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891768214 NPI number — HOWARD SCOTT SPINOWITZ DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SPINOWITZ
Provider First Name:
HOWARD
Provider Middle Name:
SCOTT
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891768214
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/22/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 15645
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89114-5645
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-877-5310
Provider Business Mailing Address Fax Number:
702-877-5310

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1600 SW ARCHER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GAINESVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32610-3003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-273-8610
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/08/2006

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: 207L00000X , with the licence number:  1231 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207L00000X , with the licence number: OS17079 , 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: 102079755 0001 . This is a "PENNSYLVANIA MEDICAID" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 1770556037 . This is a "UTAH MEDICAID" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".
  • Identifier: 944026 . This is a "ARIZONA MEDICAID" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 7616781 . This is a "NO.CAROLINA" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 114777600 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1891768214 . This is a "IDAHO MEDICAID" identifier , issued by the state of ( ID ) . This identifiers is of the category "OTHER".
  • Identifier: 742958000 . This is a "MINNESOTA MEDICAID" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 100506401 , issued by the state of ( NV ) . This identifiers is of the category "MEDICAID".
  • Identifier: XPY202877Q80 . This is a "CALIFORNIA MEDICAID" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".
  • Identifier: 200122850A . This is a "OKLAHOMA MEDICAID" identifier , issued by the state of ( OK ) . This identifiers is of the category "OTHER".
  • Identifier: 114777600 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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