Sponaugle, Marvin

Sponaugle, Marvin is an individual health care provider with primary practice located at 14547 Bruce B Downs Blvd , Tampa FL 33613-2709. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as his primary health care specialty. Sponaugle, Marvin can be contacted via phone (352) 867-8898.

Contact Information

Primary practice address
14547 Bruce B Downs Blvd Tampa FL 33613-2709
Phone: (352) 867-8898
Fax: (352) 732-6282
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X ME0045587 Florida

Profile Details

NPI number 1396798922
LBN Legal business name Sponaugle, Marvin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2006
Last updated Apr 15th, 2009 - about 15 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 1396798922 NPPES
Florida Other 62590 BLUE CROSS BLUE SHIELD
Florida MEDICAID 045458300 BLUE CROSS BLUE SHIELD
Florida Other 050011223 BLUE CROSS BLUE SHIELD

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