Provider Demographics
NPI:1821030248
Name:SPIERRE, LOUISE RUTH (MD)
Entity type:Individual
Prefix:DR
First Name:LOUISE
Middle Name:RUTH
Last Name:SPIERRE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 44008
Mailing Address - Street 2:UFJP PEDIATRIC DEPARTMENT
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32231-4008
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6271 ST. AUGUSTINE ROAD
Practice Address - Street 2:UFJP PEDIATRIC AND ADOLESCENT CENTER
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207
Practice Address - Country:US
Practice Address - Phone:904-633-0460
Practice Address - Fax:904-633-0461
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME96886208100000X, 2081P0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPediatric Rehabilitation Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL277592100Medicaid
FLP00385496OtherRR MEDICARE
FL277592100Medicaid
FLAB287YMedicare PIN