Healthcare Provider Details

I. General information

NPI: 1760818355
Provider Name (Legal Business Name): SPINE SURGERY INSTITUTE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2013
Last Update Date: 01/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8430 W BROWARD BLVD STE 200
PLANTATION FL
33324-2700
US

IV. Provider business mailing address

151 N NOB HILL RD STE 311
PLANTATION FL
33324-1708
US

V. Phone/Fax

Practice location:
  • Phone: 954-573-1720
  • Fax:
Mailing address:
  • Phone: 954-573-1720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: ASHISH SAHAI
Title or Position: MANAGING MEMBER
Credential: M.D.
Phone: 954-573-1720