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General NPI Number Information
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NPI Number | 1508729203
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Entity Type | Organization
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Legal Business Name | SYMPHONY SPINE PAIN AND NEURO ALLIANCE LLC
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Dates
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Enumeration Date | 12/08/2025
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 1671 N CLYDE MORRIS BLVD STE 100
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City | DAYTONA BEACH
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State | FL
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Zip | 32117-5590
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Country | US
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Telephone | 732-716-8112
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Fax |
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Provider Business Mailing Address
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Address Line | 1671 N CLYDE MORRIS BLVD STE 100
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City | DAYTONA BEACH
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State | FL
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Zip | 32117-5590
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Country | US
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Telephone | 732-716-8112
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MADHU MANN
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Credential |
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Telephone | 732-716-8112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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