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Organization

SPENCER DERMATOLOGY & SKIN SURGERY CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JAMES MONTGOMERY SPENCER M.D., M.S. (CEO)
(727) 572-1333
Entity
Organization

Contact information

Practice address
900 CARILLON PKWY, SUITE 404, ST PETERSBURG, FL 33716-1115
(727) 572-1333
(727) 572-1331
Mailing address
900 CARILLON PKWY, SUITE 404, ST PETERSBURG, FL 33716-1115
(727) 572-1333
(727) 572-1331

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME68471
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1730102385
NPI INDIVIDUAL NUMBER
FL
Enumeration date
06/29/2007
Last updated
06/14/2012
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