Provider Demographics
NPI:1164296968
Name:GULF COAST BRAIN AND SPINE CENTER
Entity Type:Organization
Organization Name:GULF COAST BRAIN AND SPINE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CONSTATINE
Authorized Official - Middle Name:ELEFTERIOS
Authorized Official - Last Name:PLAKAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-908-3938
Mailing Address - Street 1:10201 ARCOS AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33928-9461
Mailing Address - Country:US
Mailing Address - Phone:239-908-3938
Mailing Address - Fax:239-676-7947
Practice Address - Street 1:10201 ARCOS AVE STE 202
Practice Address - Street 2:
Practice Address - City:ESTERO
Practice Address - State:FL
Practice Address - Zip Code:33928-9461
Practice Address - Country:US
Practice Address - Phone:239-908-3938
Practice Address - Fax:239-676-7947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty