Organization
FLORIDA DETOX INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARVIN SPONAUGLE (MD)
(352) 867-8898
Entity
Organization
Contact information
Practice address
1395 S PINELLAS AVE, TARPON SPRINGS, FL 34689-3790
(352) 867-8898
(352) 732-6282
Mailing address
1501 S PINELLAS AVE STE P, SUITE P, TARPON SPRINGS, FL 34689-1952
(352) 867-8898
(352) 732-6282
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
ME45587
FL
Other
Enumeration date
08/30/2007
Last updated
08/30/2007
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