Provider Demographics
NPI:1356735377
Name:NEUROSPINE INSTITUTE LLC
Entity type:Organization
Organization Name:NEUROSPINE INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-549-9090
Mailing Address - Street 1:9325 GLADES RD
Mailing Address - Street 2:STE 205
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-3988
Mailing Address - Country:US
Mailing Address - Phone:561-549-9090
Mailing Address - Fax:561-549-9091
Practice Address - Street 1:9325 GLADES RD
Practice Address - Street 2:STE 205
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-3988
Practice Address - Country:US
Practice Address - Phone:561-549-9090
Practice Address - Fax:561-549-9091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-27
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies