Provider Demographics
NPI:1821982877
Name:SPIKES, SHATREVIA (MA, CPT)
Entity type:Individual
Prefix:
First Name:SHATREVIA
Middle Name:
Last Name:SPIKES
Suffix:
Gender:F
Credentials:MA, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2502 N LINKS AVE
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34234-2539
Mailing Address - Country:US
Mailing Address - Phone:941-302-1156
Mailing Address - Fax:
Practice Address - Street 1:2502 N LINKS AVE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34234-2539
Practice Address - Country:US
Practice Address - Phone:941-302-1156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL246Y00000X, 246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Multi-Specialty
No246Y00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health Information