Provider Demographics
NPI:1568486488
Name:SPINDELL, ROBERT FREEMAN (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:FREEMAN
Last Name:SPINDELL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 11TH ST SW
Mailing Address - Street 2:
Mailing Address - City:LIVE OAK
Mailing Address - State:FL
Mailing Address - Zip Code:32064-3608
Mailing Address - Country:US
Mailing Address - Phone:386-362-0800
Mailing Address - Fax:
Practice Address - Street 1:1100 11TH ST SW
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:FL
Practice Address - Zip Code:32064-3608
Practice Address - Country:US
Practice Address - Phone:386-362-1413
Practice Address - Fax:386-364-4503
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS5609207P00000X
GA041968207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL49895500Medicaid
B58175Medicare UPIN
FL80150QMedicare ID - Type Unspecified