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Individual
MINDY SPORN
Active
Individual
MINDY SPORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
006974
NY
363A00000X
Physician Assistant
Primary
PA9104258
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
025182100
—
FL
Enumeration date
11/20/2006
Last updated
03/15/2021
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