Healthcare Provider Details

I. General information

NPI: 1821571175
Provider Name (Legal Business Name): ORTHOPEDIC SPINE SOLUTIONS CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2018
Last Update Date: 09/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3852 SHERIDAN ST
HOLLYWOOD FL
33021-3634
US

IV. Provider business mailing address

3852 SHERIDAN ST
HOLLYWOOD FL
33021-3634
US

V. Phone/Fax

Practice location:
  • Phone: 954-983-3888
  • Fax: 954-983-3999
Mailing address:
  • Phone: 954-983-3888
  • Fax: 954-983-3999

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: BRIAN FRIEDBERG
Title or Position: CFO
Credential:
Phone: 954-983-3888