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General NPI Number Information
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NPI Number | 1396154118
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Entity Type | Organization
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Legal Business Name | INTERVENTIONAL SPINE INSTITUTE OF FLORIDA, PA
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Dates
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Enumeration Date | 08/06/2014
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1315 S INTERNATIONAL PKWY SUITE 1111
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City | LAKE MARY
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State | FL
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Zip | 32746-1407
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Country | US
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Telephone | 321-733-0064
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Fax | 321-733-7970
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Provider Business Mailing Address
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Address Line | 308 S HARBOR CITY BLVD SUITE A
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City | MELBOURNE
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State | FL
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Zip | 32901-1500
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Country | US
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Telephone | 321-733-0064
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Fax | 321-733-7970
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Authorized Official
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Title or Position | OWNER/CEO/PRESIDENT
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Name | DR. BRIAN C DOWDELL
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Credential | M.D.
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Telephone | 321-733-0064
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 60952
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 60952
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License Number State | FL
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