Provider Demographics
NPI:1891190591
Name:ALLIANCE SPINE & JOINT II, INC.
Entity Type:Organization
Organization Name:ALLIANCE SPINE & JOINT II, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAGI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAKED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-790-5037
Mailing Address - Street 1:815 SE 1ST AVE
Mailing Address - Street 2:A
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-7102
Mailing Address - Country:US
Mailing Address - Phone:954-633-7668
Mailing Address - Fax:954-633-7690
Practice Address - Street 1:2221 N UNIVERSITY DR
Practice Address - Street 2:SUITE B
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-3603
Practice Address - Country:US
Practice Address - Phone:954-633-7668
Practice Address - Fax:954-633-7690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-24
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service