Provider Demographics
NPI:1326157082
Name:SPIESS, PHILIPPE (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIPPE
Middle Name:
Last Name:SPIESS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12902 USF MAGNOLIA DR
Mailing Address - Street 2:GU PROGRAM
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-9416
Mailing Address - Country:US
Mailing Address - Phone:813-745-8343
Mailing Address - Fax:813-745-8494
Practice Address - Street 1:12902 USF MAGNOLIA DR
Practice Address - Street 2:GU PROGRAM
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-9416
Practice Address - Country:US
Practice Address - Phone:813-745-8343
Practice Address - Fax:813-745-8494
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME99232208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL90619OtherBCBS
FL278614100Medicaid
FL278614100Medicaid