Basic Information
| Provider Information | |||||||||
| NPI: | 1588822456 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SPAGNOLO-HYE | ||||||||
| FirstName: | CAROL | ||||||||
| MiddleName: | LEE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12744 SW 207TH TER | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331775524 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4073194396 | ||||||||
| FaxNumber: | 3052240126 | ||||||||
| Practice Location | |||||||||
| Address1: | 6 SAND HILL RD STE 102 | ||||||||
| Address2: | |||||||||
| City: | FLEMINGTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088224946 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9087826700 | ||||||||
| FaxNumber: | 9087885861 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/28/2008 | ||||||||
| LastUpdateDate: | 09/08/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/08/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | OS10552 | FL | N | Allopathic & Osteopathic Physicians | General Practice | 208000000X | OS 10377 | FL | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 000226300 | 05 | FL | MEDICAID |