Provider Demographics
NPI:1497141238
Name:SPENCE, SEAN ANTHONY (MD)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:ANTHONY
Last Name:SPENCE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1641 TAMIAMI TRL
Mailing Address - Street 2:STE 1
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33948-1018
Mailing Address - Country:US
Mailing Address - Phone:941-629-6262
Mailing Address - Fax:941-629-1782
Practice Address - Street 1:1641 TAMIAMI TRL STE 1
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33948-1018
Practice Address - Country:US
Practice Address - Phone:941-629-6262
Practice Address - Fax:941-629-1782
Is Sole Proprietor?:No
Enumeration Date:2015-04-08
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME148758207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery