Irena Spivak

Primary specialty

DentistTaxonomy code 122300000X

License

DN21536 Issued in FL

Practice address

4125 Cleveland Ave
Suite 1430
Fort Myers, FL 33901-9046

Phone

(239) 939-9050

Fax

(239) 939-9054

NPI assigned

Aug 24, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1440374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440374400000",
    "number": "1932576113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4125 CLEVELAND AVE",
            "address_2": "SUITE 1430",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019046",
            "telephone_number": "239-939-9050",
            "fax_number": "239-939-9054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4125 CLEVELAND AVE",
            "address_2": "SUITE 1430",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019046",
            "telephone_number": "239-939-9050",
            "fax_number": "239-939-9054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPIVAK",
        "first_name": "IRENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-24",
        "last_updated": "2015-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN21536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucia Spinelli, PA-C
• Natalia Spinelli, MD
• Shannon R Spirgatis, CRNA
• Julianne Carroll Spiros, DO
• Ellie Spithourakis, CRNA, ARNP
• Sports and Spine Inc
• Sports Specialty & Rehabilitation Center Inc
• Sonya Diann Spradley, CCC-SLP
• Gerard Vincent Sprague, LMHC
• Sonia A Spratlin

• Dentist in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.