Provider Demographics
NPI:1952932493
Name:SPIELER, LISEL (PA-C)
Entity Type:Individual
Prefix:
First Name:LISEL
Middle Name:
Last Name:SPIELER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1173 FINS UP CT
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32124-3719
Mailing Address - Country:US
Mailing Address - Phone:954-756-1010
Mailing Address - Fax:
Practice Address - Street 1:1173 FINS UP CT
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32124-3719
Practice Address - Country:US
Practice Address - Phone:954-756-1010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-03
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty