Provider Demographics
NPI:1497989909
Name:GULFCOAST SPINAL CENTER, INC.
Entity Type:Organization
Organization Name:GULFCOAST SPINAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:SAVIGNANO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-816-9616
Mailing Address - Street 1:8515 OLD CR 54
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-6420
Mailing Address - Country:US
Mailing Address - Phone:727-816-9616
Mailing Address - Fax:727-816-9618
Practice Address - Street 1:7136 LITTLE ROAD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34654
Practice Address - Country:US
Practice Address - Phone:727-816-9616
Practice Address - Fax:727-816-9618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-12
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8969111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty