# THE SPINE INSTITUTE OF FLORIDA PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043029788
- **Authorized official:** JOCELYN RAE IDEMA DO (ORTHOPEDIC SURGEON)
- **Authorized official phone:** (412) 997-0494

## Contact information

- **Practice address:** 1905 CLINT MOORE RD STE 300, BOCA RATON, FL 33496-2661
- **Practice address phone:** (412) 997-0494
- **Mailing address:** 1825 PONCE DE LEON BLVD \# 142, CORAL GABLES, FL 33134-4418
- **Mailing address phone:** (412) 997-0494

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/07/2025
- **Last updated:** 01/07/2025