Provider Demographics
NPI:1770549263
Name:SPALDING, HELEN MARY ANNE
Entity type:Individual
Prefix:DR
First Name:HELEN
Middle Name:MARY ANNE
Last Name:SPALDING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8240 CLEARY BLVD
Mailing Address - Street 2:#2412
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-1384
Mailing Address - Country:US
Mailing Address - Phone:954-258-0456
Mailing Address - Fax:954-518-9701
Practice Address - Street 1:4100 HOLLYWOOD BLVD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-6778
Practice Address - Country:US
Practice Address - Phone:954-518-4100
Practice Address - Fax:954-518-9701
Is Sole Proprietor?:No
Enumeration Date:2006-04-24
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 92888174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG06717Medicare UPIN