Healthcare Provider Details

I. General information

NPI: 1992705487
Provider Name (Legal Business Name): FLORIDA JOINT & SPINE INSTITUTE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 10/31/2023
Certification Date: 10/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5115 US HIGHWAY 27 N STE 100
SEBRING FL
33870-1323
US

IV. Provider business mailing address

5115 US HIGHWAY 27 N STE 100
SEBRING FL
33870-1323
US

V. Phone/Fax

Practice location:
  • Phone: 863-385-2222
  • Fax: 863-382-8765
Mailing address:
  • Phone: 863-385-2222
  • Fax: 863-382-8765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JUAN CARLOS ALVAREZ
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 863-385-2222