Healthcare Provider Details

I. General information

NPI: 1538565122
Provider Name (Legal Business Name): JOINT & SPINE MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2014
Last Update Date: 11/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2151 E COMMERCIAL BLVD SUITE 303
FT LAUDERDALE FL
33308-3807
US

IV. Provider business mailing address

2151 E COMMERCIAL BLVD SUITE 303
FT LAUDERDALE FL
33308-3807
US

V. Phone/Fax

Practice location:
  • Phone: 954-907-0370
  • Fax: 954-533-8500
Mailing address:
  • Phone: 954-907-0370
  • Fax: 954-533-8500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberOS8932
License Number StateFL

VIII. Authorized Official

Name: DANNELL B ANSCHUETZ
Title or Position: PHYSICIAN
Credential: D.O.
Phone: 954-907-0370