Healthcare Provider Details

I. General information

NPI: 1326540295
Provider Name (Legal Business Name): SOUTH FLORIDA SPINAL NEUROSURGERY ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2018
Last Update Date: 02/13/2023
Certification Date: 02/13/2023
Deactivation Date: 03/30/2021
Reactivation Date: 03/09/2022

III. Provider practice location address

7805 NW BEACON SQUARE BLVD STE 103
BOCA RATON FL
33487-1396
US

IV. Provider business mailing address

1770 S OCEAN BLVD APT 201
POMPANO BEACH FL
33062-7802
US

V. Phone/Fax

Practice location:
  • Phone: 800-964-4395
  • Fax: 954-634-4293
Mailing address:
  • Phone: 503-706-8272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY HARRY OPPENHEIMER
Title or Position: OWNER
Credential: MD
Phone: 800-964-4395