Provider Demographics
NPI:1427054709
Name:SPIEGEL, JEFFREY M (DPM)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:M
Last Name:SPIEGEL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1921 WALDEMERE ST
Mailing Address - Street 2:STE 106
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2941
Mailing Address - Country:US
Mailing Address - Phone:941-917-6232
Mailing Address - Fax:941-917-7231
Practice Address - Street 1:1921 WALDEMERE ST
Practice Address - Street 2:STE 106
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2941
Practice Address - Country:US
Practice Address - Phone:941-917-6232
Practice Address - Fax:941-917-7231
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 1474213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T55541Medicare UPIN
21570Medicare ID - Type Unspecified