Active NPI
Michael Edward Spanburgh, RPH
- Pharmacist
- Altamonte Springs, FL
National Provider Identifier
1154926517
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS0029112
- Practice address
- 277 WSR 436
Altamonte Springs, FL 32714 - Phone
- (407) 389-6025
- NPI assigned
- Dec 3, 2020
- Last updated
- Dec 3, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS0029112 | FL | Primary |
Addresses
Primary practice location
277 WSR 436
Altamonte Springs, FL 32714
Mailing address
1000 Via Como PL
Lake Mary, FL 32746-1553
Phone (407) 389-6025
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)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS0029112 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holiday CVS LLC | Past | Accepting new patients | |
| Holiday CVS L.L.C. | Past | Accepting new patients |
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": "1606953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606953600000",
"number": "1154926517",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 VIA COMO PL",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327461553",
"telephone_number": "407-389-6025"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "277 WSR 436",
"city": "ALTAMONTE SPRINGS",
"state": "FL",
"postal_code": "32714",
"telephone_number": "407-389-6025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPANBURGH",
"first_name": "MICHAEL",
"middle_name": "EDWARD",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-03",
"last_updated": "2020-12-03",
"certification_date": "2020-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS0029112",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Altamonte Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.