Provider Demographics
NPI:1700110483
Name:FLORIDA SPINE SPECIALISTS LLC
Entity Type:Organization
Organization Name:FLORIDA SPINE SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KALMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BLUMBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-771-2551
Mailing Address - Street 1:6000 N FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-2226
Mailing Address - Country:US
Mailing Address - Phone:954-771-2551
Mailing Address - Fax:954-492-5266
Practice Address - Street 1:6000 NORTH FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-1772
Practice Address - Country:US
Practice Address - Phone:954-771-2551
Practice Address - Fax:954-492-5266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-28
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty