Organization Name: | FLORIDA SPINE & PAIN INSTITUTE, LLC |
NPI Number: | 1053769661 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DARA SANCHEZ (VICE PRESIDENT) |
Mailing Address: | 835 Oak Shadows Rd Suite 1 Celebration |
State: | FL US |
Postal Code: | 347474227 |
Phone Number: | 8886634435 |
Fax Number: | |
NPI Enumeration Date: | 05/25/2016 |
NPI Last Update Date: | 05/25/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QH0100X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Health Service |
Taxonomy Definition: |