Provider Demographics
NPI:1962812586
Name:SPINE REHABILITATION SPECIALISTS INC
Entity Type:Organization
Organization Name:SPINE REHABILITATION SPECIALISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SONATA
Authorized Official - Middle Name:
Authorized Official - Last Name:LABANAUSKIENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-923-0999
Mailing Address - Street 1:4000 SAWYER RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-1272
Mailing Address - Country:US
Mailing Address - Phone:941-923-0999
Mailing Address - Fax:941-923-0090
Practice Address - Street 1:4000 SAWYER RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-1272
Practice Address - Country:US
Practice Address - Phone:941-923-0999
Practice Address - Fax:941-923-0090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-05
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty