Provider Demographics
NPI:1750155107
Name:MINIMALLY INVASIVE NEUROSURGICAL INSTITUTE INC
Entity type:Organization
Organization Name:MINIMALLY INVASIVE NEUROSURGICAL INSTITUTE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MBR
Authorized Official - Prefix:
Authorized Official - First Name:DEEPA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-642-5957
Mailing Address - Street 1:2125 SE 25TH LOOP
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-1009
Mailing Address - Country:US
Mailing Address - Phone:352-642-5957
Mailing Address - Fax:
Practice Address - Street 1:2125 SE 25TH LOOP
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-1009
Practice Address - Country:US
Practice Address - Phone:352-642-5957
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty