Provider Demographics
NPI:1720851991
Name:NEUSPINE INSTITUTE LLC
Entity Type:Organization
Organization Name:NEUSPINE INSTITUTE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DEUKMEDJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-333-1186
Mailing Address - Street 1:8468 NORTHCLIFFE BLVD
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-1140
Mailing Address - Country:US
Mailing Address - Phone:813-333-1186
Mailing Address - Fax:844-691-5928
Practice Address - Street 1:8468 NORTHCLIFFE BLVD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-1140
Practice Address - Country:US
Practice Address - Phone:813-333-1186
Practice Address - Fax:844-691-5928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty