Provider Demographics
NPI:1235431875
Name:HARMONY SPINE AND DISC
Entity Type:Organization
Organization Name:HARMONY SPINE AND DISC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:V
Authorized Official - Last Name:HANSBROUGH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:772-287-7701
Mailing Address - Street 1:500 SE DIXIE HWY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-3054
Mailing Address - Country:US
Mailing Address - Phone:772-287-7701
Mailing Address - Fax:772-220-4473
Practice Address - Street 1:500 SE DIXIE HWY
Practice Address - Street 2:SUITE 2
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-3054
Practice Address - Country:US
Practice Address - Phone:772-287-7701
Practice Address - Fax:772-220-4473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-02
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 3653261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service