Provider Demographics
NPI:1730188376
Name:SPIRO, ROBERT H (PHD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:H
Last Name:SPIRO
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 N FEDERAL HWY STE 102E
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-5179
Mailing Address - Country:US
Mailing Address - Phone:413-441-9261
Mailing Address - Fax:561-361-0409
Practice Address - Street 1:4800 N FEDERAL HWY STE 102E
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-5179
Practice Address - Country:US
Practice Address - Phone:413-441-9261
Practice Address - Fax:561-361-0409
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-15
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY9850103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAQ21146Medicare UPIN
MDW01633Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID