Provider Demographics
NPI:1356301030
Name:SPECHT, ERIC PAUL (PT)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:PAUL
Last Name:SPECHT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5165 ADANSON ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-1331
Mailing Address - Country:US
Mailing Address - Phone:407-303-9603
Mailing Address - Fax:407-303-8031
Practice Address - Street 1:5165 ADANSON ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-1331
Practice Address - Country:US
Practice Address - Phone:407-303-9603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-25
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 183582251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPT 18358OtherFL STATE LIC. #