Provider Demographics
NPI:1891189973
Name:AMERICAN SPINE & ORTHOPAEDIC INSTITUTE, LLC
Entity Type:Organization
Organization Name:AMERICAN SPINE & ORTHOPAEDIC INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAAVEDRA
Authorized Official - Suffix:
Authorized Official - Credentials:MHA
Authorized Official - Phone:407-440-2728
Mailing Address - Street 1:7824 LAKE UNDERHILL RD STE H
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-8201
Mailing Address - Country:US
Mailing Address - Phone:407-440-2728
Mailing Address - Fax:407-792-4152
Practice Address - Street 1:7824 LAKE UNDERHILL ROAD SUITE H
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822
Practice Address - Country:US
Practice Address - Phone:877-977-7463
Practice Address - Fax:407-792-4152
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERICAN SPINE & ORTHOPAEDIC INSTITUTE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-03-26
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME82473207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty