Provider Demographics
NPI:1245413194
Name:WESTON MEDICAL HEALTH CENTER, LLC
Entity Type:Organization
Organization Name:WESTON MEDICAL HEALTH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:SPOONHOUR
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:954-888-6650
Mailing Address - Street 1:2237 N COMMERCE PKWY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-3250
Mailing Address - Country:US
Mailing Address - Phone:954-888-6650
Mailing Address - Fax:954-888-6645
Practice Address - Street 1:2237 N COMMERCE PKWY STE 2
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3250
Practice Address - Country:US
Practice Address - Phone:954-888-6650
Practice Address - Fax:954-888-6645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-14
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8366111N00000X
FLOS9560207Q00000X
2081S0010X
FLPT3412225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6288960001Medicare NSC