Individual
DR. JOSEPH WILLIAM SPADAFORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
21275 OLEAN BLVD, PORT CHARLOTTE, FL 33952-6704
(941) 625-1325
(941) 625-0131
Mailing address
21275 OLEAN BLVD, PORT CHARLOTTE, FL 33952-6704
(941) 625-1325
(941) 625-0131
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
OS4567
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39680000
—
FL
01
—
80101Z
MEDICARE PTAN
FL
Enumeration date
07/14/2005
Last updated
10/04/2011
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