Provider Demographics
NPI:1578178380
Name:SPINEUGENIX LLC
Entity Type:Organization
Organization Name:SPINEUGENIX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREIRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-845-0233
Mailing Address - Street 1:7429 MONTE VERDE
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34238-4562
Mailing Address - Country:US
Mailing Address - Phone:941-845-0233
Mailing Address - Fax:941-538-6063
Practice Address - Street 1:2030 BEE RIDGE RD STE B
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-6108
Practice Address - Country:US
Practice Address - Phone:941-845-0233
Practice Address - Fax:941-538-6063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-09
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty