Healthcare Provider Details

I. General information

NPI: 1851979066
Provider Name (Legal Business Name): SOUTH FLORIDA SPINAL NEUROSURGERY ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2021
Last Update Date: 02/13/2023
Certification Date: 02/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7805 NW BEACON SQUARE BLVD
BOCA RATON FL
33487-1395
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: 561-325-6072
Mailing address:
  • Phone: 954-634-4292
  • Fax: 954-634-4293

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
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

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