Individual provider Active NPI

Teresa Spano, ND, CNS

  • Nutritionist
  • Fort Myers, FL
National Provider Identifier
1063844678
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
ND8843 Issued in FL
Practice address
1570 Colonial Blvd Ste a
Fort Myers, FL 33907-1031
Phone
(239) 766-7311
NPI assigned
Aug 6, 2013
Last updated
Feb 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X ND8843 FL Primary
Naturopath 175F00000X 500 CT

Addresses

Primary practice location

1570 Colonial Blvd Ste a
Fort Myers, FL 33907-1031

Mailing address

18 School St
Glastonbury, CT 06033-2241

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
500CTMDNaturopath

Practice roles

OrganizationSpecialtyStatusNew patients
SWFL Integrative Medicine, P.a. CurrentSince Feb 18, 2024 Accepting new patients
Glastonbury Naturopathic Center LLC Naturopath Past Accepting new patients

Locations

1570 Colonial Blvd
Ste A
Fort Myers, FL 33907
Phone (239) 208-6676

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1375747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1063844678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 SCHOOL ST",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1570 COLONIAL BLVD STE A",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071031",
            "telephone_number": "239-766-7311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPANO",
        "first_name": "TERESA",
        "name_prefix": "Dr.",
        "credential": "ND, CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-06",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "FL",
            "license": "ND8843",
            "primary": true
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "CT",
            "license": "500",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.