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General NPI Number Information
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NPI Number | 1891934402
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Entity Type | Organization
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Legal Business Name | GULFCOAST SPINE INSTITUTE, LLC
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Dates
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Enumeration Date | 02/05/2009
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Last Update Date | 11/07/2023
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Provider Practice Location Address
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Address Line | 7101 MARINER BLVD
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City | BROOKSVILLE
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State | FL
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Zip | 34609-1048
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Country | US
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Telephone | 855-485-3262
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Fax | 813-443-8255
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Provider Business Mailing Address
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Address Line | 4211 W BOY SCOUT BLVD SUITE 400
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City | TAMPA
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State | FL
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Zip | 33607-5724
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Country | US
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Telephone | 813-443-2108
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Fax | 813-443-8255
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JAMES JOSEPH RONZO
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Credential | DO
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Telephone | 813-443-2108
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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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Taxonomy #2
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State |
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