Provider Demographics
NPI:1023538089
Name:SOUTH MIAMI SPINE AND JOINT LLC
Entity type:Organization
Organization Name:SOUTH MIAMI SPINE AND JOINT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CINDI
Authorized Official - Middle Name:
Authorized Official - Last Name:PASCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-726-6809
Mailing Address - Street 1:7000 SW 62ND AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4716
Mailing Address - Country:US
Mailing Address - Phone:305-595-1095
Mailing Address - Fax:305-271-1855
Practice Address - Street 1:7000 SW 62ND AVE STE 201
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4716
Practice Address - Country:US
Practice Address - Phone:305-595-1095
Practice Address - Fax:305-271-1855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-21
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty