Organization
ORANGE PARK NEUROSURGERY P.L.
Active
Organization
ORANGE PARK NEUROSURGERY P.L.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK A SPATOLA MD (MANAGING MEMBER)
(904) 276-3376
Entity
Organization
Contact information
Practice address
2021 KINGSLEY AVE, SUITE 101, ORANGE PARK, FL 32073-5174
(904) 276-3376
(904) 276-5308
Mailing address
2021 KINGSLEY AVE, SUITE 101, ORANGE PARK, FL 32073-5174
(904) 276-3376
(904) 276-5308
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K7538
MEDICARE PTAN
FL
Enumeration date
07/28/2006
Last updated
01/14/2015
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