Provider Demographics
NPI:1942940408
Name:HANSHAW, SPENCER DANIEL II
Entity Type:Individual
Prefix:MR
First Name:SPENCER
Middle Name:DANIEL
Last Name:HANSHAW
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14265 CREEKBED CIR
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-4529
Mailing Address - Country:US
Mailing Address - Phone:407-360-7332
Mailing Address - Fax:
Practice Address - Street 1:14265 CREEKBED CIR
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-4529
Practice Address - Country:US
Practice Address - Phone:407-360-7332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-31
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL342000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes342000000XTransportation ServicesTransportation Network Company