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NPI Code Detail

MEDICARE: MIAMI BACK INSTITUTE

MEDICARE: MIAMI BACK INSTITUTE
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
1208100000XPhysical Medicine & Rehabilitation Physician

General Provider Information

NPI Number : 1497828933
Entity Type Code : Organization
Provider Name (Legal Business Name) : MIAMI BACK INSTITUTE
Provider Business Mailing Address
First Line : 1825 PONCE DE LEON BLVD # 387
Second Line :
City : CORAL GABLES
State : FL
Zip : 33134-4418
Country : US
Telephone Number : 305-461-4848
Fax Number : 305-461-4899
Provider Business Practice Location Address
First Line : 315 PALERMO AVE
Second Line :
City : CORAL GABLES
State : FL
Zip : 33134-6607
Country : US
Telephone Number : 305-461-4848
Fax Number : 305-461-4899
Authorized Official
Title or Position : PRESIDENT
Name : DR. GARY ALAN ROBERTSON
Credential : D.C.
Telephone Number : 305-461-4848
Provider Enumeration Date : 11/15/2006
Last Update Date : 08/22/2020

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Directions to “MIAMI BACK INSTITUTE ” Practice Location

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