Individual
MICHAEL J SPAGNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2080 CHILD ST, JACKSONVILLE, FL 32214-5005
(904) 542-7312
Mailing address
380 ST. JOHNS FOREST BLVD, JACKSONVILLE, FL 32259-8009
(904) 400-4824
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
9302131
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN 9302131
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002595900
—
FL
05
—
003149099D
—
GA
Enumeration date
01/23/2006
Last updated
09/03/2015
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