Provider Demographics
NPI:1710171517
Name:MICHELLE SPUZA MILORD MD PA
Entity Type:Organization
Organization Name:MICHELLE SPUZA MILORD MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:S
Authorized Official - Last Name:SPUZA MILORD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-319-4535
Mailing Address - Street 1:5100 SEMINOLE BLVD
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33708-3354
Mailing Address - Country:US
Mailing Address - Phone:727-319-4535
Mailing Address - Fax:727-319-4528
Practice Address - Street 1:5100 SEMINOLE BLVD
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33708-3354
Practice Address - Country:US
Practice Address - Phone:727-319-4535
Practice Address - Fax:727-319-4528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME91341207R00000X, 207RA0201X
FLME061160207RR0500X
FLMRE91341207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & ImmunologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK3856Medicare PIN