Provider Demographics
NPI:1093996076
Name:FLORIDA SPINE INSTITUTE
Entity Type:Organization
Organization Name:FLORIDA SPINE INSTITUTE
Other - Org Name:ASHRAF F HANNA MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADM ASST HUMAN RESOURCES MGR
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MIKHAIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-724-5005
Mailing Address - Street 1:2250 DREW ST
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-3305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2250 DREW ST
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-3305
Practice Address - Country:US
Practice Address - Phone:727-797-7463
Practice Address - Fax:727-465-5192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-19
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0070421332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site
Provider Identifiers
StateIdentifier IDID TypeIssuer
1017816OtherOTHER ID NUMBER