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Contact Information

RESTORE BRAIN SPORT AND SPINE
11603 SHELDON ROAD
TAMPA, FL33626
 Phone: 516-680-8080
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

2081P2900X 25 Physician/Physical Medicine and Rehabilitation
Indicates primary specialty

NPI Profile & details for RESTORE BRAIN SPORT AND SPINE

NPI # 1376378091
LBN Legal business name RESTORE BRAIN SPORT AND SPINE
Authorized official THOMAS REILLY - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 09/03/2024
Last updated 03/25/2025 - More than a year ago
Identifiers n/a
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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