Organization · NPI-2

Center For Spine Medicine PA

· Ocala, FL

NPI number1821218488
StatusActive
Last updated in NPPESJun 27, 2008

Details

NPI
1821218488
Entity type
Organization (NPI-2)
Legal business name
Center For Spine Medicine PA
Organization subpart
No
Enumeration date
Apr 26, 2007
Last updated
Jun 27, 2008

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208VP0000X ME 61060FLYes

Practice location

3200 Sw 34th Ave
Suite 502
Ocala, FL 34474-7456

Phone 352-629-7011 · Fax 352-629-7924

Mailing address

3200 Sw 34th Ave
Suite 502
Ocala, FL 34474-7456

Phone 352-629-7011 · Fax 352-629-7924

Authorized official

Charles Michael Grudem
President
3526297011

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