Provider Demographics
NPI:1184196370
Name:DAYTONA SPINE INSTITUTE
Entity Type:Organization
Organization Name:DAYTONA SPINE INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROHIT
Authorized Official - Middle Name:K
Authorized Official - Last Name:KHANNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-271-8110
Mailing Address - Street 1:1400 DUNLAWTON AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32127-8952
Mailing Address - Country:US
Mailing Address - Phone:386-271-8110
Mailing Address - Fax:386-760-0084
Practice Address - Street 1:1400 DUNLAWTON AVE
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32127-8952
Practice Address - Country:US
Practice Address - Phone:386-271-8110
Practice Address - Fax:386-760-0084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-28
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty