Provider Demographics
NPI:1205293966
Name:COMPREHENSIVE SPINE AND REGENERATIVE MEDICINE, INC
Entity type:Organization
Organization Name:COMPREHENSIVE SPINE AND REGENERATIVE MEDICINE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSOCIATE
Authorized Official - Prefix:
Authorized Official - First Name:SABINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SWINDAL
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:407-412-5030
Mailing Address - Street 1:9145 NARCOOSSEE RD STE A200
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-5768
Mailing Address - Country:US
Mailing Address - Phone:407-412-5030
Mailing Address - Fax:407-601-7946
Practice Address - Street 1:9145 NARCOOSSEE RD # A-200
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-5768
Practice Address - Country:US
Practice Address - Phone:407-412-5030
Practice Address - Fax:407-601-7946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-25
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME73164208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIM930AMedicare PIN