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General NPI Number Information
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NPI Number | 1639681471
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Entity Type | Organization
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Legal Business Name | BRIGANTTI ANESTHESIA & SPINE CARE
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Dates
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Enumeration Date | 11/02/2017
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Last Update Date | 11/02/2017
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Provider Practice Location Address
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Address Line | 1361 13TH AVE SOUTH SUITE #210
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City | JACKSONVILLE
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State | FL
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Zip | 32224
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Country | US
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Telephone | 407-994-5909
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Fax |
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Provider Business Mailing Address
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Address Line | 1361 13TH AVE S STE 210
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City | JACKSONVILLE
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State | FL
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Zip | 32250-3236
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Country | US
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Telephone | 407-994-5909
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. RUBEN XAVIER PAGAN
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Credential | MD
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Telephone | 407-994-5909
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State | FL
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