Provider Demographics
NPI:1912529868
Name:SPIEVACK, EDWARD FRANK
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:FRANK
Last Name:SPIEVACK
Suffix:
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 1:30 W HIGH POINT RD
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34996-7020
Mailing Address - Country:US
Mailing Address - Phone:772-221-9250
Mailing Address - Fax:772-221-9225
Practice Address - Street 1:30 W HIGH POINT RD
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34996-7020
Practice Address - Country:US
Practice Address - Phone:772-221-9250
Practice Address - Fax:772-221-9225
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-14
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME21001207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery