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General NPI Number Information
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NPI Number | 1609548254
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Entity Type | Organization
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Legal Business Name | NORTH FLORIDA ORTHOPEDIC AND SPINE, PLLC
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Dates
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Enumeration Date | 10/01/2021
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Last Update Date | 05/25/2023
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Provider Practice Location Address
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Address Line | 657 E ROMANA ST
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City | PENSACOLA
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State | FL
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Zip | 32502-6111
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Country | US
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Telephone | 850-446-2909
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Fax |
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Provider Business Mailing Address
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Address Line | 4400 STATE HIGHWAY 121 STE 405
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City | LEWISVILLE
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State | TX
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Zip | 75056
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Country | US
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Telephone | 469-459-9754
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Fax |
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Authorized Official
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Title or Position | CRO
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Name | SETH JACKNOWITZ
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Credential |
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Telephone | 469-459-9754
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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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