Provider Demographics
NPI:1437241072
Name:SPRUILL, LAUREL ELAINE (MD)
Entity Type:Individual
Prefix:DR
First Name:LAUREL
Middle Name:ELAINE
Last Name:SPRUILL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1842 KARLETON PL S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33712-6031
Mailing Address - Country:US
Mailing Address - Phone:727-322-1304
Mailing Address - Fax:727-322-1248
Practice Address - Street 1:3420 8TH AVE S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33711-2204
Practice Address - Country:US
Practice Address - Phone:727-322-1304
Practice Address - Fax:727-322-1248
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0069158207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine