Organization
CARLOS E. SPERA, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RACHEL MITCHELL CPCHI (DIRECTOR)
(919) 477-5152
Entity
Organization
Contact information
Practice address
12575 ORANGE DRIVE #303, DAVIE, FL 33330
(954) 577-8585
(954) 577-8556
Mailing address
PO BOX 15385, DURHAM, NC 27704-0385
(919) 477-5152
(919) 477-5474
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1196
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1196
LICENSE
FL
01
—
2964
CERTIFICATE NUMBER
FL
Enumeration date
02/02/2010
Last updated
03/02/2010
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