Provider Demographics
NPI:1306373410
Name:SPINA, ROBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:
Last Name:SPINA
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 1:35 GOTTENHAM STREET
Mailing Address - Street 2:
Mailing Address - City:GLEBE
Mailing Address - State:NSW
Mailing Address - Zip Code:02037
Mailing Address - Country:AU
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:35 GOTTENHAM STREET
Practice Address - Street 2:
Practice Address - City:GLEBE
Practice Address - State:NSW
Practice Address - Zip Code:02037
Practice Address - Country:AU
Practice Address - Phone:614-307-3542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-19
Last Update Date:2017-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program