1891768214 NPI number — HOWARD SCOTT SPINOWITZ DO

Table of content: HOWARD SCOTT SPINOWITZ DO (NPI 1891768214)

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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