Provider Demographics
NPI:1306831672
Name:SPOTO, DANIEL VINCENT (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:VINCENT
Last Name:SPOTO
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 1:2650 BAHIA VISTA ST
Mailing Address - Street 2:STE 201
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2635
Mailing Address - Country:US
Mailing Address - Phone:941-957-1150
Mailing Address - Fax:941-957-1311
Practice Address - Street 1:2650 BAHIA VISTA ST
Practice Address - Street 2:STE 201
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2635
Practice Address - Country:US
Practice Address - Phone:941-957-1150
Practice Address - Fax:941-957-1311
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00445802084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL30742OtherBLUECROSS BLUESHIELD
FL30742OtherBLUECROSS BLUESHIELD