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General NPI Number Information
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NPI Number | 1609051150
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Entity Type | Organization
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Legal Business Name | SPINE AND PAIN MEDICINE CENTER PA
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Dates
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Enumeration Date | 01/03/2008
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Last Update Date | 05/16/2017
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Provider Practice Location Address
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Address Line | 8811 STATE ROAD 52 SUITE 21
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City | HUDSON
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State | FL
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Zip | 34667-6784
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Country | US
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Telephone | 727-861-2277
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Fax | 727-861-2062
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Provider Business Mailing Address
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Address Line | 8811 STATE ROAD 52 SUITE 21
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City | HUDSON
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State | FL
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Zip | 34667-6784
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Country | US
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Telephone | 727-861-2277
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Fax | 727-861-2062
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DANIEL H BENDER
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Credential | M.D.
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Telephone | 727-861-2277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME0060231
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License Number State | FL
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