Spain, Gregory C

Spain, Gregory C is an sole proprietor health care provider with primary practice located at 11323 Reflection Isles Blvd , Fort Myers FL 33912. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Spain, Gregory C can be contacted via phone (239) 919-6896.

Contact Information

Primary practice address
11323 Reflection Isles Blvd Fort Myers FL 33912
Phone: (239) 919-6896
Fax: (239) 219-6158
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X PO3323 Florida

Profile Details

NPI number 1942378724
LBN Legal business name Spain, Gregory C
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 1st, 2006
Last updated Oct 21st, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942378724 NPPES
Pennsylvania Other 413476 BLUE SHIELD
Pennsylvania Other 302558 BLUE SHIELD
Pennsylvania Other 2082528 BLUE SHIELD
Pennsylvania MEDICAID 004057100 BLUE SHIELD
Pennsylvania Other 3014221 BLUE SHIELD

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