Provider Demographics
NPI:1548786890
Name:ALLEGIANCE ORTHOPAEDIC & SPINE INSTITUTE PLLC
Entity Type:Organization
Organization Name:ALLEGIANCE ORTHOPAEDIC & SPINE INSTITUTE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ELDON
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-330-4358
Mailing Address - Street 1:190 CONGRESS AVE
Mailing Address - Street 2:STE 160
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-4707
Mailing Address - Country:US
Mailing Address - Phone:561-330-4358
Mailing Address - Fax:561-330-4390
Practice Address - Street 1:9033 GLADES RD STE B
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-3939
Practice Address - Country:US
Practice Address - Phone:561-330-4358
Practice Address - Fax:561-330-4390
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALLEGIANCE ORTHOPAEDIC & SPINE INSTITUTE PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-08-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME86962207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty