Healthcare Provider Details

I. General information

NPI: 1457462731
Provider Name (Legal Business Name): PINNACLE BRAIN AND SPINE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 09/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 AIRPORT BLVD STE D146
MOBILE AL
36608-6701
US

IV. Provider business mailing address

6701 AIRPORT BLVD STE D146
MOBILE AL
36608-6701
US

V. Phone/Fax

Practice location:
  • Phone: 251-633-5155
  • Fax: 251-633-5125
Mailing address:
  • Phone: 251-633-5155
  • Fax: 251-633-5125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number00012906
License Number StateAL

VIII. Authorized Official

Name: DR. JUAN FELIX RONDEROS
Title or Position: MD/OWNER
Credential: MD
Phone: 251-633-5155