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General NPI Number Information
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NPI Number | 1629759428
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Entity Type | Organization
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Legal Business Name | MIAMI SPINE SPECIALISTS LLC
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Dates
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Enumeration Date | 07/26/2023
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Last Update Date | 07/26/2023
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Provider Practice Location Address
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Address Line | 2801 NE 213TH ST STE 809
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City | AVENTURA
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State | FL
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Zip | 33180-1264
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Country | US
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Telephone | 305-532-0065
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Fax |
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Provider Business Mailing Address
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Address Line | 4308 ALTON RD STE 830
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City | MIAMI BEACH
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State | FL
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Zip | 33140-4558
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Country | US
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Telephone | 305-532-0065
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Fax |
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Authorized Official
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Title or Position | AO
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Name | JONATHAN ALLEN HYDE
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Credential | MD
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Telephone | 305-532-0065
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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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