Florida Detox Inc

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

ME45587 Issued in FL

Legal business name

FLORIDA DETOX INC

Practice address

1395 S Pinellas Ave
Tarpon Springs, FL 34689-3790

Phone

(352) 867-8898

Fax

(352) 732-6282

NPI assigned

Aug 30, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Marvin Sponaugle

Title

MD

Phone

(352) 867-8898

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188432000000",
    "number": "1902090152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 S PINELLAS AVE STE P",
            "address_2": "SUITE P",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346891952",
            "telephone_number": "352-867-8898",
            "fax_number": "352-732-6282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 S PINELLAS AVE",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346893790",
            "telephone_number": "352-867-8898",
            "fax_number": "352-732-6282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA DETOX INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-30",
        "last_updated": "2007-08-30",
        "status": "A",
        "authorized_official_last_name": "SPONAUGLE",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "352-867-8898",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "FL",
            "license": "ME45587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pain Medicine Physician in Tarpon Springs, FL
• Providers in Tarpon Springs, FL by specialty
• Pain Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2007; 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.