Healthcare Provider Details

I. General information

NPI: 1386016137
Provider Name (Legal Business Name): INTERNATIONAL SPINE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2015
Last Update Date: 10/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 GULF BLVD APT 2G
CLEARWATER FL
33767-2859
US

IV. Provider business mailing address

1310 GULF BLVD APT 2G
CLEARWATER FL
33767-2859
US

V. Phone/Fax

Practice location:
  • Phone: 844-774-6335
  • Fax:
Mailing address:
  • Phone: 844-774-6335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREW C MESSER
Title or Position: CHIEF OF SURGERY
Credential: M.D.
Phone: 844-774-6335