Basic Information
| Provider Information | |||||||||
| NPI: | 1942620760 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FERDERIGOS | ||||||||
| FirstName: | SPIROS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 201 14TH ST SW | ||||||||
| Address2: | |||||||||
| City: | LARGO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337703133 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7275882200 | ||||||||
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| Practice Location | |||||||||
| Address1: | 201 14TH ST SW | ||||||||
| Address2: | |||||||||
| City: | LARGO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33770 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7275885200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/19/2014 | ||||||||
| LastUpdateDate: | 05/16/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | OS14205 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.