Provider Demographics
NPI:1053440784
Name:SPAR, JEFFREY FRANKLIN (PHD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:FRANKLIN
Last Name:SPAR
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9485 SW 72ND ST
Mailing Address - Street 2:SUITE A222
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3242
Mailing Address - Country:US
Mailing Address - Phone:305-279-0007
Mailing Address - Fax:305-279-7407
Practice Address - Street 1:9485 SW 72ND ST
Practice Address - Street 2:SUITE A222
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3242
Practice Address - Country:US
Practice Address - Phone:305-279-0007
Practice Address - Fax:305-279-7407
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical