Provider Demographics
NPI:1578887675
Name:SEA SPINE ORTHOPEDICS INSTITUTE LLC
Entity Type:Organization
Organization Name:SEA SPINE ORTHOPEDICS INSTITUTE LLC
Other - Org Name:SEA SPINE ORTHOPEDIC INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:JOSHUA
Authorized Official - Last Name:APPEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:888-816-7846
Mailing Address - Street 1:3350 NW 53RD ST STE 102
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-6354
Mailing Address - Country:US
Mailing Address - Phone:866-816-7846
Mailing Address - Fax:954-458-2928
Practice Address - Street 1:6001 VINELAND RD STE 116
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7829
Practice Address - Country:US
Practice Address - Phone:866-816-7846
Practice Address - Fax:954-458-2928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-17
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL615061100OtherDOL