Provider Demographics
NPI:1083896591
Name:SPATOLA, GIOVANNI S (MD)
Entity Type:Individual
Prefix:DR
First Name:GIOVANNI
Middle Name:S
Last Name:SPATOLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:901 N LAKE DESTINY RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-4844
Mailing Address - Country:US
Mailing Address - Phone:407-200-2860
Mailing Address - Fax:407-200-1365
Practice Address - Street 1:12500 S APOPKA VINELAND RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32836-6723
Practice Address - Country:US
Practice Address - Phone:407-934-2273
Practice Address - Fax:407-934-2279
Is Sole Proprietor?:No
Enumeration Date:2007-11-27
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 100073207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine