MEDICARE: COMPREHENSIVE SPINE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207T00000X	Neurological Surgery Physician
2	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1326411075
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPREHENSIVE SPINE, INC.

Provider Business Mailing Address
First Line	:	3618 LANTANA RD
Second Line	:	SUITE 202
City	:	LAKE WORTH
State	:	FL
Zip	:	33462-2246
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3618 LANTANA RD
Second Line	:	SUITE 202
City	:	LAKE WORTH
State	:	FL
Zip	:	33462-2246
Country	:	US
Telephone Number	:	561-296-2450
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	ERIC WEINBERGER
Credential	:
Telephone Number	:	561-801-3971

Provider Enumeration Date	:	11/03/2015
Last Update Date	:	11/03/2015

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Directions to “COMPREHENSIVE SPINE, INC. ” Practice Location

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