Healthcare Provider Details

I. General information

NPI: 1578887675
Provider Name (Legal Business Name): SEA SPINE ORTHOPEDICS INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2010
Last Update Date: 06/03/2022
Certification Date: 06/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 VINELAND RD STE 116
ORLANDO FL
32819-7829
US

IV. Provider business mailing address

3350 NW 53RD ST STE 102
FT LAUDERDALE FL
33309-6354
US

V. Phone/Fax

Practice location:
  • Phone: 866-816-7846
  • Fax: 954-458-2928
Mailing address:
  • Phone: 866-816-7846
  • Fax: 954-458-2928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: ANDREW JOSHUA APPEL
Title or Position: PHYSICIAN OWNER
Credential: MD
Phone: 888-816-7846