Provider Demographics
NPI:1427372887
Name:ADVENT ORTHOPEDICS AND NEUROSURGERY PA
Entity Type:Organization
Organization Name:ADVENT ORTHOPEDICS AND NEUROSURGERY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPANGLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-209-6572
Mailing Address - Street 1:4820 PARK BLVD N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-3534
Mailing Address - Country:US
Mailing Address - Phone:727-209-6572
Mailing Address - Fax:727-209-6685
Practice Address - Street 1:4820 PARK BLVD N
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-3534
Practice Address - Country:US
Practice Address - Phone:727-544-0320
Practice Address - Fax:727-209-6693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-15
Last Update Date:2016-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207T00000X, 207X00000X
FLME0063164335E00000X
FLME0053164207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic SurgeryGroup - Single Specialty
No207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009163500Medicaid
615318900OtherUS DEPT OF LABOR
615318900OtherUS DEPARTMENT OF LABOR
FL003WZOtherBLUE SHIELD OF FLORIDA
FL8885314OtherAETNA
DS2394OtherRAILROAD MEDICARE
FL009163500Medicaid
FL6495350001Medicare NSC