Provider Demographics
NPI:1528004934
Name:NEUROSURGICAL ASSOCIATES OF TAMPA BAY, INC.
Entity Type:Organization
Organization Name:NEUROSURGICAL ASSOCIATES OF TAMPA BAY, INC.
Other - Org Name:BRAIN2SPINE INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NADINE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-828-8400
Mailing Address - Street 1:603 7TH ST S
Mailing Address - Street 2:SUITE 540
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4719
Mailing Address - Country:US
Mailing Address - Phone:727-828-8400
Mailing Address - Fax:727-828-8401
Practice Address - Street 1:603 7TH ST S STE 540
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4734
Practice Address - Country:US
Practice Address - Phone:727-828-8411
Practice Address - Fax:727-828-8401
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEUROSURGICAL ASSOCIATES OF TAMPA BAY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-22
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6697960001OtherDME PTAN
FLDC7963OtherRAILROAD MEDICARE
FL271117600Medicaid
FL94728OtherBCBS
FL271117600Medicaid