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General NPI Number Information
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NPI Number | 1669340840
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Entity Type | Organization
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Legal Business Name | ACADEMIC SPINE CONSULTANTS, LLC
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Dates
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Enumeration Date | 10/28/2025
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 9602 VESCOVATO WAY
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City | BOCA RATON
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State | FL
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Zip | 33496-3830
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Country | US
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Telephone | 312-450-5880
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Fax | 312-577-0800
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Provider Business Mailing Address
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Address Line | 9602 VESCOVATO WAY
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City | BOCA RATON
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State | FL
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Zip | 33496-3830
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Country | US
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Telephone | 312-450-5880
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Fax | 312-577-0800
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. SERGEY NECKRYSH
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Credential | MD
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Telephone | 312-450-5880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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