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Contact Information

INSTITUTE FOR HEALTH SPORTS SPINE REHABILITATION & PAIN MANAGE
1895 KINGSLEY AVE STE 1005B
ORANGE PARK, FL32073-4466
 Phone: 904-647-5266
 Fax: 904-770-5594
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Interventional Pain Medicine

208VP0014X 09 Physician/Interventional Pain Management
Indicates primary specialty

NPI Profile & details for INSTITUTE FOR HEALTH SPORTS SPINE REHABILITATION & PAIN MANAGE

NPI Number 1184171605
LBN Legal business name INSTITUTE FOR HEALTH SPORTS SPINE REHABILITATION & PAIN MANAGE
Authorized official BRIDGET ROBERTS - (ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 09/01/2016
Last updated 08/13/2025 - About 10 months ago
Identifiers
FL License # ME117856
FL Medicaid 014945000
FL Other 1154714129 NPI
FL Other 1487954723 NPI
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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