Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Multi-Specialty |
261QM1300X | 70 | Clinic or Group Practice | |
Durable Medical Equipment & Medical Supplies |
332B00000X | 54 | Other Medical Supply Company | |
Orthopaedic Surgery |
207X00000X | 02 | Physician/General Surgery |
| NPI # | 1578135968 |
||||
| LBN Legal business name | CENTER FOR SPINE AND ORTHOPEDICS PC | ||||
| Authorized official | DEBBIE LUCERO - (CREDENTIALING COORDINATOR) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | Yes | ||||
| Enumeration date | 07/14/2021 | ||||
| Last updated | 07/14/2021 - About 5 years ago | ||||
| Identifiers |
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