Organization

Spine Center Of Fl Llc

Interventional Pain Medicine Physician in Bonita Springs, FL(View on Map)

Legal Business Name

Spine Center Of Fl Llc

NPI Number

1861043929

NPI Type

Organization

Enumeration Date

09/20/2019

Specialties

(Taxonomies)

Code

208VP0014X
208VP0000X

Primary Taxonomy

Yes
No

Contact
Information

Purpose

Mailing
Location

Address

11921 ROCKVILLE PIKE STE 505
9400 BONITA BEACH RD SE STE 101

City

Rockville
Bonita Springs

State

MD
FL

Postal Code

20852-2758
34135-4520

Country

US
US

Telephone Number

(301) 945-5111
(239) 333-1177

Authorized Official

Name

Douglas Wisor

Title or Position

OFFICER

Telephone Number

(703) 927-5772

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 09/20/2019

Provider Address

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