Healthcare Provider Details

I. General information

NPI: 1457974552
Provider Name (Legal Business Name): ALL SPINE CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2020
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 N MCMULLEN BOOTH RD STE B1
CLEARWATER FL
33759-2100
US

IV. Provider business mailing address

1700 N MCMULLEN BOOTH RD STE B1
CLEARWATER FL
33759-2100
US

V. Phone/Fax

Practice location:
  • Phone: 727-580-7747
  • Fax: 727-245-8879
Mailing address:
  • Phone: 727-474-7411
  • Fax: 833-974-2140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State

VIII. Authorized Official

Name: ANDREW MOULTON
Title or Position: OWNER
Credential: MD
Phone: 347-546-5674