Provider Demographics
NPI:1003869686
Name:SPOOR, LORI A (DO)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:A
Last Name:SPOOR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 W. KENNEDY BVLD.
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-2501
Mailing Address - Country:US
Mailing Address - Phone:813-844-1385
Mailing Address - Fax:813-254-0230
Practice Address - Street 1:1717 COLUMBIA RD NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-2803
Practice Address - Country:US
Practice Address - Phone:202-469-4699
Practice Address - Fax:813-254-0230
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9996207Q00000X
DCDO210001812207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1012659340001Medicaid
FLAD0792OtherMEDICARE
FL278198100Medicaid
PA1012659340001Medicaid
PA095707Medicare ID - Type Unspecified
FLAD0792OtherMEDICARE