Individual provider Active NPI

Spencer Eth, M.D.

  • Psychiatry Physician
  • Aventura, FL
National Provider Identifier
1114974433
Registry record updated Mar 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME108229 Issued in FL
Practice address
20281 E Country Club Dr
#508
Aventura, FL 33180-3010
Phone
(201) 370-0276
Fax
(305) 936-9947
NPI assigned
May 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ME108229 FL Primary

Addresses

Primary practice location

20281 E Country Club Dr
#508
Aventura, FL 33180-3010

Mailing address

20281 E Country Club Dr
#508
Aventura, FL 33180-3010
Phone (201) 370-0276

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME108229FLMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301443200000",
    "number": "1114974433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20281 E COUNTRY CLUB DR",
            "address_2": "#508",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331803010",
            "telephone_number": "201-370-0276",
            "fax_number": "305-936-9947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20281 E COUNTRY CLUB DR",
            "address_2": "#508",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331803010",
            "telephone_number": "201-370-0276",
            "fax_number": "305-936-9947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETH",
        "first_name": "SPENCER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2011-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME108229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aventura, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2011; 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.