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BRAIN AND SPINE WORK ASSESSMENT AND THERAPY CENTER NPI 1992913040


NPI Information

NPI: 1992913040
Provider Name: BRAIN AND SPINE WORK ASSESSMENT AND THERAPY CENTER
Classification: Specialist - 174400000X
Entity Type: Organization

CLIA Number: 10D2009645

Address:
2101 NORTHSIDE DR
SUITE 502
PANAMA CITY, FL
ZIP 32405
Phone: (850) 913-7040
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BRAIN AND SPINE WORK ASSESSMENT AND THERAPY CENTER is a specialist in Panama City, FL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. BRAIN AND SPINE WORK ASSESSMENT AND THERAPY CENTER NPI is 1992913040. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2101 NORTHSIDE DR
SUITE 502
PANAMA CITY, FL
ZIP 32405-685
Phone: (850) 913-7040
Fax: (850) 913-0290

The provider's authorized official is Ron Samuelian .
The authorized official title is Ceo and has the following contact phone number (850) 747-0400.

The CLIA number assigned to this NPI record is 10D2009645 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/21/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialistPT4387FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1Y924SOTHERFLORIDABCBS SUPER Y GROUP #

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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