Provider Demographics
NPI:1205054806
Name:SPUZA, MICHAEL P (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:P
Last Name:SPUZA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10700 JOHNSON BLVD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33772-4821
Mailing Address - Country:US
Mailing Address - Phone:727-397-2500
Mailing Address - Fax:727-397-2489
Practice Address - Street 1:10700 JOHNSON BLVD
Practice Address - Street 2:SUITE 3
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33772-4821
Practice Address - Country:US
Practice Address - Phone:727-397-2500
Practice Address - Fax:727-397-2489
Is Sole Proprietor?:No
Enumeration Date:2007-04-22
Last Update Date:2008-07-01
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Provider Licenses
StateLicense IDTaxonomies
FLME60429207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL12852OtherBLUE CROSS BLUE SHIELD