Provider Demographics
NPI:1205204633
Name:INTERNATIONAL SPINE AND SPORTS INSTITUTE
Entity Type:Organization
Organization Name:INTERNATIONAL SPINE AND SPORTS INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:KATZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-947-3081
Mailing Address - Street 1:652 PALM SPRINGS DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-7838
Mailing Address - Country:US
Mailing Address - Phone:407-947-3081
Mailing Address - Fax:
Practice Address - Street 1:652 PALM SPRINGS DR
Practice Address - Street 2:SUITE A
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-7838
Practice Address - Country:US
Practice Address - Phone:407-947-3081
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-02
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical