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Gulfcoast Spine Institute, Pa

NPI Registration Record

Provider / OrganizationNPIDate Certified
GULFCOAST SPINE INSTITUTE, PA16599806542020-07-24
Other Names:
Entity TypeOrganization
Provider OrganizationGULFCOAST SPINE INSTITUTE, PA
Practice Office Address439 S FLORIDA AVE STE 300
LAKELAND, FL US
Practice Office Telephone8134432108
Practice Office Fax8134438255
Mailing Address4211 W BOY SCOUT BLVD STE 400
TAMPA, FL 336075766 US
Business Telephone8134432108
Business Fax8134438255
Authorized OfficialJAMES J RONZO, PRESIDENT
8134432108
HPT Codes
CodeLicense NoState
207X00000X PRIMARY
193400000X SINGGroup Code
OPI Codes
Governmental Registrations [CAGE/NCAGE/DUNS]

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