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General NPI Number Information
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NPI Number | 1073409629
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Entity Type | Organization
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Legal Business Name | NEXTGEN SPINE CENTER, LLC
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Dates
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Enumeration Date | 06/17/2025
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 1820 WELLNESS LN BLDG 4
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City | TRINITY
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State | FL
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Zip | 34655-5357
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Country | US
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Telephone | 878-867-7463
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Fax |
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Provider Business Mailing Address
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Address Line | 1536 KISH BLVD
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City | TRINITY
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State | FL
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Zip | 34655-5310
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Country | US
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Telephone | 727-809-0377
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Fax |
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Authorized Official
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Title or Position | VP
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Name | MR. MARCELO DANIEL EGUINO
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Credential |
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Telephone | 727-809-0377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State |
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