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General NPI Number Information
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NPI Number | 1760721849
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Entity Type | Organization
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Legal Business Name | CENTRAL SPINE AND ORTHOPEDIC CENTER, LLC
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Dates
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Enumeration Date | 02/08/2013
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Last Update Date | 05/13/2016
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Provider Practice Location Address
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Address Line | 150 S ANDREWS AVE SUITE 201
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City | POMPANO BEACH
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State | FL
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Zip | 33069-3298
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Country | US
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Telephone | 954-476-9494
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Fax | 954-476-8288
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Provider Business Mailing Address
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Address Line | 150 S ANDREWS AVE SUITE 201
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City | POMPANO BEACH
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State | FL
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Zip | 33069-3298
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Country | US
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Telephone | 954-941-2969
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Fax | 954-476-8288
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Authorized Official
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Title or Position | HEAD NURSE MANAGER
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Name | MRS. STACEY CASTROVINCI
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Credential | RN
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Telephone | 954-586-5212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | ME54695
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OS7123
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License Number State | FL
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