Provider Demographics
NPI:1922047398
Name:SPILLER, DENNIS M (DO)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:M
Last Name:SPILLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8362 PINES BLVD
Mailing Address - Street 2:STE 279
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-6600
Mailing Address - Country:US
Mailing Address - Phone:954-967-6550
Mailing Address - Fax:954-893-6818
Practice Address - Street 1:3702 WASHINGTON ST
Practice Address - Street 2:SUITE 303
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-8282
Practice Address - Country:US
Practice Address - Phone:954-967-6550
Practice Address - Fax:954-967-6553
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2021-03-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS 3980207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL068366301Medicaid
FLD84699Medicare UPIN
FL068366301Medicaid