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General NPI Number Information
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NPI Number | 1760204176
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Entity Type | Organization
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Legal Business Name | SPINE CLINIC PHYSICIAN LLC
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 7550 FUTURES DR 104
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City | ORLANDO
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State | FL
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Zip | 32819
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Country | US
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Telephone | 689-305-8328
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Fax | 407-530-4326
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Provider Business Mailing Address
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Address Line | 5628 RHONDA CT
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City | ZEPHYRHILLS
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State | FL
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Zip | 33542
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Country | US
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Telephone | 813-834-1688
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTIC DIRECTOR
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Name | DR. ALBERTO MARTINEZ
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Credential | DC, BCN
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Telephone | 813-834-1688
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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