Provider Demographics
NPI:1598985988
Name:GERALD L. SPOTO, D.D.S., P.A.
Entity Type:Organization
Organization Name:GERALD L. SPOTO, D.D.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:L
Authorized Official - Last Name:SPOTO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:813-884-3287
Mailing Address - Street 1:5420 WEBB ROAD
Mailing Address - Street 2:SUITE A-2
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-3255
Mailing Address - Country:US
Mailing Address - Phone:813-884-3287
Mailing Address - Fax:813-884-6977
Practice Address - Street 1:5420 WEBB RD
Practice Address - Street 2:SUITE A-2
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-3250
Practice Address - Country:US
Practice Address - Phone:813-884-3287
Practice Address - Fax:813-884-6977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL53411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherTAX ID