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NPI Code Detail

MEDICARE: MD SPINE NOW, LLC

MEDICARE: MD SPINE NOW, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207XS0117XOrthopaedic Surgery of the Spine Physician

General Provider Information

NPI Number : 1073944583
Entity Type Code : Organization
Provider Name (Legal Business Name) : MD SPINE NOW, LLC
Provider Business Mailing Address
First Line : 3618 LANTANA RD
Second Line : SUITE 101
City : LAKE WORTH
State : FL
Zip : 33462-2246
Country : US
Telephone Number : 561-298-1188
Fax Number : 855-440-2220
Provider Business Practice Location Address
First Line : 3618 LANTANA RD
Second Line : SUITE 101
City : LAKE WORTH
State : FL
Zip : 33462-2246
Country : US
Telephone Number : 561-298-1188
Fax Number : 855-440-2220
Authorized Official
Title or Position : OFFICE ADMINISTRATOR
Name : JACQUELIN WALKER
Credential :
Telephone Number : 561-296-1188
Provider Enumeration Date : 12/09/2013
Last Update Date : 12/09/2013

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Directions to “MD SPINE NOW, LLC ” Practice Location

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