Provider Demographics
NPI:1558560151
Name:SPIEGEL, JUSTIN (PT)
Entity Type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:
Last Name:SPIEGEL
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 1:1940 BRUCE B DOWNS BLVD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-9262
Mailing Address - Country:US
Mailing Address - Phone:813-991-1555
Mailing Address - Fax:813-991-1515
Practice Address - Street 1:1940 BRUCE B DOWNS BLVD
Practice Address - Street 2:SUITE 107
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-9262
Practice Address - Country:US
Practice Address - Phone:813-991-1555
Practice Address - Fax:813-991-1515
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23432225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist