Provider Demographics
NPI:1477276657
Name:ELITE ORTHOPEDICS & SPINE LLC
Entity type:Organization
Organization Name:ELITE ORTHOPEDICS & SPINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:PINNEO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-517-8167
Mailing Address - Street 1:2660 10TH AVE S STE 107
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-1622
Mailing Address - Country:US
Mailing Address - Phone:888-315-2615
Mailing Address - Fax:
Practice Address - Street 1:2660 10TH AVE S STE 107
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1622
Practice Address - Country:US
Practice Address - Phone:888-315-2615
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-22
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty