Healthcare Provider Details

I. General information

NPI: 1750100491
Provider Name (Legal Business Name): CSPRING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2024
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2302 WINTHROP AVE SW
ROANOKE VA
24015-3131
US

IV. Provider business mailing address

2302 WINTHROP AVE SW
ROANOKE VA
24015-3131
US

V. Phone/Fax

Practice location:
  • Phone: 786-368-3640
  • Fax:
Mailing address:
  • Phone: 786-368-3640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: JUAN SEBASTIAN CARDENAS
Title or Position: CEO - FUONDER
Credential:
Phone: 540-524-9211