Provider Demographics
NPI:1609034735
Name:SPANN, APRIL D (LMT NCTMB)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:D
Last Name:SPANN
Suffix:
Gender:F
Credentials:LMT NCTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 ROBIN LN
Mailing Address - Street 2:
Mailing Address - City:WINTER HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:33884-2589
Mailing Address - Country:US
Mailing Address - Phone:863-899-3585
Mailing Address - Fax:
Practice Address - Street 1:1020 ROBIN LN
Practice Address - Street 2:
Practice Address - City:WINTER HAVEN
Practice Address - State:FL
Practice Address - Zip Code:33884-2589
Practice Address - Country:US
Practice Address - Phone:863-899-3585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA53358225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMA53358OtherDEPARTMENT OF HEALTH