Provider Demographics
NPI:1245325802
Name:SPEER, CARL GRANBERRY (MD)
Entity type:Individual
Prefix:
First Name:CARL
Middle Name:GRANBERRY
Last Name:SPEER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 S DADELAND BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-2866
Mailing Address - Country:US
Mailing Address - Phone:865-303-8207
Mailing Address - Fax:305-675-3378
Practice Address - Street 1:204 CENTER ST
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32561-4392
Practice Address - Country:US
Practice Address - Phone:850-477-2597
Practice Address - Fax:866-939-1533
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME47671207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL059123842OtherBCBS OF ALABAMA
FL17651OtherBCBS OF FLORIDA
FL042743800Medicaid
000285530006OtherUNITED HEALTH CARE
AL009509870Medicaid
100007816OtherRAILROAD MEDICARE
4321992OtherAETNA
Z011OtherHEALTH OPTIONS
4925602OtherCIGNA
Z011OtherHEALTH OPTIONS
AL059123842OtherBCBS OF ALABAMA
AL000033641Medicare PIN