Individual
MARVIN SPONAUGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14547 BRUCE B DOWNS BLVD, TAMPA, FL 33613-2709
(352) 867-8898
(352) 732-6282
Mailing address
PO BOX 862362, ORLANDO, FL 32886-2362
(352) 867-8898
(352) 732-6282
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
ME0045587
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
045458300
—
FL
01
—
050011223
RAILROAD MEDICARE
FL
01
—
62590
BLUE CROSS BLUE SHIELD
FL
Enumeration date
05/17/2006
Last updated
04/15/2009
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