Individual
IRENA SPIVAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4125 CLEVELAND AVE, SUITE 1430, FORT MYERS, FL 33901-9046
(239) 939-9050
(239) 939-9054
Mailing address
4125 CLEVELAND AVE, SUITE 1430, FORT MYERS, FL 33901-9046
(239) 939-9050
(239) 939-9054
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN21536
FL
Other
Enumeration date
08/24/2015
Last updated
08/24/2015
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