Provider Demographics
NPI:1801696075
Name:DAVID B SPANO PHD PLLC
Entity type:Organization
Organization Name:DAVID B SPANO PHD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:B
Authorized Official - Last Name:SPANO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:980-999-0540
Mailing Address - Street 1:18538 COASTAL SHORE TER
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34638-0164
Mailing Address - Country:US
Mailing Address - Phone:980-999-0540
Mailing Address - Fax:704-396-8698
Practice Address - Street 1:18538 COASTAL SHORE TER
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34638-0164
Practice Address - Country:US
Practice Address - Phone:980-999-0540
Practice Address - Fax:704-396-8698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty