Spencer Dermatology & Skin Surgery Center LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME68471 Issued in FL

Legal business name

SPENCER DERMATOLOGY & SKIN SURGERY CENTER LLC

Practice address

900 Carillon Pkwy
Suite 404
St Petersburg, FL 33716-1115

Phone

(727) 572-1333

Fax

(727) 572-1331

NPI assigned

Jun 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. James Montgomery Spencer, M.D., M.S.

Title

Ceo

Phone

(727) 572-1333

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339632000000",
    "number": "1104023324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 CARILLON PKWY",
            "address_2": "SUITE 404",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337161115",
            "telephone_number": "727-572-1333",
            "fax_number": "727-572-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 CARILLON PKWY",
            "address_2": "SUITE 404",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337161115",
            "telephone_number": "727-572-1333",
            "fax_number": "727-572-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPENCER DERMATOLOGY & SKIN SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-29",
        "last_updated": "2012-06-14",
        "status": "A",
        "authorized_official_last_name": "SPENCER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "MONTGOMERY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "727-572-1333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., M.S."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME68471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL NUMBER",
            "identifier": "1730102385",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Seeta Rani Spence Banfield, CRNA
• Audra Spence
• Colleen Helen Spence
• Tisha L Spence, M.D.
• Stephne Spenceley, CPNP-AC/PC
• Deborah Downs Spencer, PH.D.
• Elitsa Spencer, RN IBCLC
• Stephanie Spencer
• Donna Sperber, M.D.
• Harry B Sperber, MD

• Specialist in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2012; 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.