Provider Demographics
NPI:1336489749
Name:SPITZER, PATRICIA KATHLEEN (PA)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:KATHLEEN
Last Name:SPITZER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:KATHLEEN
Other - Last Name:POLICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:1950 LAUREL MANOR DR STE 224
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162-5602
Mailing Address - Country:US
Mailing Address - Phone:352-751-6565
Mailing Address - Fax:352-205-7777
Practice Address - Street 1:1950 LAUREL MANOR DR STE 224
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162
Practice Address - Country:US
Practice Address - Phone:352-751-6565
Practice Address - Fax:352-205-7777
Is Sole Proprietor?:No
Enumeration Date:2013-02-21
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9106818363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant