Provider Demographics
NPI:1497067987
Name:TOTAL SPINAL SOLUTIONS LLC
Entity Type:Organization
Organization Name:TOTAL SPINAL SOLUTIONS LLC
Other - Org Name:TOTAL SPINAL SOLUTIONS INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:PATRONI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-916-4964
Mailing Address - Street 1:1300 SHORELINE DR
Mailing Address - Street 2:STE. 104
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32561
Mailing Address - Country:US
Mailing Address - Phone:850-932-8774
Mailing Address - Fax:850-932-8705
Practice Address - Street 1:1300 SHORELINE DRIVE
Practice Address - Street 2:STE. 104
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32561
Practice Address - Country:US
Practice Address - Phone:850-932-8774
Practice Address - Fax:850-932-8705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-13
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1000002707261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy