Provider Demographics
NPI:1427370493
Name:ARINETA SPEER MD PA
Entity Type:Organization
Organization Name:ARINETA SPEER MD PA
Other - Org Name:ARINETA SPEER,MDPA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARINETA
Authorized Official - Middle Name:NMN
Authorized Official - Last Name:SPEER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-433-9229
Mailing Address - Street 1:1124 E YONGE ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-4778
Mailing Address - Country:US
Mailing Address - Phone:850-433-9229
Mailing Address - Fax:850-433-9237
Practice Address - Street 1:1124 E YONGE ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-4778
Practice Address - Country:US
Practice Address - Phone:850-433-9229
Practice Address - Fax:850-433-9237
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARINETA SPEER,MD PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-02-18
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL50895207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL062232000Medicaid
08788OtherBLUE CROSS
FLE31285Medicare UPIN
08788OtherBLUE CROSS