Provider Demographics
NPI:1457300816
Name:SPITZER, BRIAN PAUL SR (PD)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:PAUL
Last Name:SPITZER
Suffix:SR
Gender:M
Credentials:PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 ROMA CT
Mailing Address - Street 2:#3104
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-6453
Mailing Address - Country:US
Mailing Address - Phone:239-566-1291
Mailing Address - Fax:239-566-1291
Practice Address - Street 1:519 ROMA CT
Practice Address - Street 2:#3104
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-6453
Practice Address - Country:US
Practice Address - Phone:239-566-1291
Practice Address - Fax:239-566-1291
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS28670183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist