Healthcare Provider Details

I. General information

NPI: 1306801840
Provider Name (Legal Business Name): FLORENCE NEUROSURGERY AND SPINE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 06/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1204 E CHEVES ST
FLORENCE SC
29506-2710
US

IV. Provider business mailing address

1204 E CHEVES ST
FLORENCE SC
29506-2710
US

V. Phone/Fax

Practice location:
  • Phone: 843-673-0122
  • Fax: 843-673-0227
Mailing address:
  • Phone: 843-673-0122
  • Fax: 843-673-0227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number
License Number StateSC
# 4
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number StateSC

VIII. Authorized Official

Name: DR. WILLIAM B NASO
Title or Position: PRESIDENT
Credential: MD
Phone: 843-673-0122