=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710381322
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | QUALITY SPINE CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/11/2014
-----------------------------------------------------
Last Update Date | 10/11/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 600 N CONGRESS AVE 120
-----------------------------------------------------
City | DELRAY BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33445-3464
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-279-3020
-----------------------------------------------------
Fax | 561-275-5027
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 600 N CONGRESS AVE 120
-----------------------------------------------------
City | DELRAY BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33445-3464
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-279-3020
-----------------------------------------------------
Fax | 561-275-5027
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. MICHAEL B FINKELSTEIN
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 561-352-1115
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | CH7628
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------