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General NPI Number Information
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NPI Number | 1386952554
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Entity Type | Organization
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Legal Business Name | TOTAL SPINE CARE ASSOCIATES OF SOUTH FLORIDA, LLC
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Dates
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Enumeration Date | 09/21/2010
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Last Update Date | 12/23/2011
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Provider Practice Location Address
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Address Line | 3650 NW 82ND AVE SUITE 201
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City | DORAL
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State | FL
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Zip | 33166-6658
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Country | US
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Telephone | 305-716-8348
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Fax | 305-716-8359
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Provider Business Mailing Address
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Address Line | PO BOX 160
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City | CIRCLE PINES
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State | MN
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Zip | 55014-0160
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Country | US
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Telephone | 612-669-7173
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Fax | 651-490-7797
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Authorized Official
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Title or Position | OWNER
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Name | JUAN M RAPOSO
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Credential | M.D.
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Telephone | 305-716-8348
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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 | ME 104124
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License Number State | FL
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