Provider Demographics
NPI:1841735701
Name:SPINE AND ORTHOPAEDIC SPECIALISTS OF CENTRAL FLORIDA, LLC
Entity Type:Organization
Organization Name:SPINE AND ORTHOPAEDIC SPECIALISTS OF CENTRAL FLORIDA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-507-0800
Mailing Address - Street 1:2090 PALM BEACH LAKES BLVD
Mailing Address - Street 2:STE 202
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-6523
Mailing Address - Country:US
Mailing Address - Phone:561-507-0800
Mailing Address - Fax:
Practice Address - Street 1:395 S WICKHAM RD
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32904-1135
Practice Address - Country:US
Practice Address - Phone:561-507-0800
Practice Address - Fax:561-600-8705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-03
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty