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Contact Information

CENTER FOR SPINE MEDICINE PA
3200 SW 34TH AVE
SUITE 502
OCALA, FL34474-7456
 Phone: 352-629-7011
 Fax: 352-629-7924
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

208VP0000X 72 Physician/Pain Management
Indicates primary specialty

NPI Profile & details for CENTER FOR SPINE MEDICINE PA

NPI # 1821218488
LBN Legal business name CENTER FOR SPINE MEDICINE PA
Authorized official CHARLES GRUDEM - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 04/26/2007
Last updated 06/27/2008 - About 18 years ago
Identifiers
FL License # ME 61060
FL Other 94747 BCBS GROUP
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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