Organization
MARVIN L SPONAUGLE MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARVIN SPONAUGLE MD (PRESIDENT)
(352) 867-8898
Entity
Organization
Contact information
Practice address
1395 S PINELLAS AVE, TARPON SPRINGS, FL 34689-3790
(352) 867-8898
(352) 732-6282
Mailing address
PO BOX 864091, ORLANDO, FL 32886-4091
(352) 867-8898
(352) 732-6282
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME45587
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
62590
BLUE CROSS BLUE SHIELD
FL
Enumeration date
12/26/2006
Last updated
09/12/2007
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