Provider Demographics
NPI:1205820743
Name:STEINDEL-SPARGO, BETHEL SUSAN (MD)
Entity Type:Individual
Prefix:
First Name:BETHEL
Middle Name:SUSAN
Last Name:STEINDEL-SPARGO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BETHEL
Other - Middle Name:
Other - Last Name:STEINDEL-KOPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2900 CORPORATE WAY
Mailing Address - Street 2:DOOR D
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3925
Mailing Address - Country:US
Mailing Address - Phone:954-276-5685
Mailing Address - Fax:954-985-7074
Practice Address - Street 1:1951 SW 172ND AVE STE 204
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33029-5613
Practice Address - Country:US
Practice Address - Phone:954-538-4621
Practice Address - Fax:954-538-4629
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME767722080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL255188800Medicaid