Lawrence D Spack, MD

Primary specialty

Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X

License

ME74105 Issued in FL

Practice address

92 W Miller St
Orlando, FL 32806-2032

Phone

(321) 841-5104

Fax

(321) 841-6871

NPI assigned

Aug 25, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Orlando Health Medical Group Inc

  • Internal Medicine Physician
  • Orlando, FL
  • NPI 1669429577
  Medicare reassignment NPD
• Childrens Critical Care Associates

  • Pediatric Critical Care Medicine Physician
  • Orlando, FL
  • NPI 1982712667
  NPD
• Orlando Health Medical Group Inc

  • Durable Medical Equipment & Medical Supplies
  • Winter Park, FL
  • NPI 1265019541
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1043327752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 W MILLER ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062032",
            "telephone_number": "321-841-5104",
            "fax_number": "321-841-6871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 W MILLER ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062032",
            "telephone_number": "321-841-5104",
            "fax_number": "321-841-6871"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1033 Dr Martin Luther King Jr St N",
            "address_2": "Suite 108",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337011547",
            "country_code": "US",
            "telephone_number": "727-456-4250",
            "fax_number": "727-346-1044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPACK",
        "first_name": "LAWRENCE",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "FL",
            "license": "ME74105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253085600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lori Sowa, CRNA
• Brianna Sowers
• Sofia Mae Sozio
• Arelis M Sozzi, RBT
• Spa Longevita Acupuncture & Herbal Medicine
• Angela S Spadaro, MA CCC SLP
• Gabriella Spadaro
• Anthony Frank Spadavecchio, L.M.T.
• Jackie Spain
• Howard Kenneth Spalding, MD

• Pediatric Critical Care Medicine Physician in Orlando, FL
• Providers in Orlando, FL by specialty
• Pediatric Critical Care Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.