Healthcare Provider Details

I. General information

NPI: 1295623825
Provider Name (Legal Business Name): SPINE AND PAIN INSTITUTE OF NONA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2025
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5200 HOFFNER AVE
ORLANDO FL
32812-2432
US

IV. Provider business mailing address

11954 NARCOOSSEE RD STE 2561O882
ORLANDO FL
32832-6998
US

V. Phone/Fax

Practice location:
  • Phone: 407-326-6898
  • Fax: 407-326-6882
Mailing address:
  • Phone: 407-326-6898
  • Fax: 407-326-6882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code204R00000X
TaxonomyElectrodiagnostic Medicine Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: BHARAT C PATEL
Title or Position: MD/CEO
Credential: MD
Phone: 407-326-6898