Provider Demographics
NPI:1174848329
Name:SPINE INSTITUTE, P.A.
Entity Type:Organization
Organization Name:SPINE INSTITUTE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-965-0436
Mailing Address - Street 1:PO BOX 540064
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33454-0064
Mailing Address - Country:US
Mailing Address - Phone:561-965-0436
Mailing Address - Fax:561-965-0452
Practice Address - Street 1:4897 S JOG RD STE A
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33467-5000
Practice Address - Country:US
Practice Address - Phone:561-965-0436
Practice Address - Fax:561-965-0452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-31
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME90015207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty