Healthcare Provider Details

I. General information

NPI: 1275320574
Provider Name (Legal Business Name): SPINE AND HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2025
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10631 N KENDALL DR STE 145
MIAMI FL
33176-1559
US

IV. Provider business mailing address

10631 N KENDALL DR STE 145
MIAMI FL
33176-1559
US

V. Phone/Fax

Practice location:
  • Phone: 786-618-9908
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. VIVIAN CARMONA
Title or Position: DIRECTOR
Credential:
Phone: 786-618-9908