# PSL ORTHO SPINE CORP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Apex Ortho Spine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154040640
- **Authorized official:** LAURA C BEATTY (PRACTICE MANAGER)
- **Authorized official phone:** (772) 262-0852

## Contact information

- **Practice address:** 266 NW PEACOCK BLVD STE 204, PORT ST LUCIE, FL 34986-2271
- **Practice address phone:** (772) 262-0852
- **Practice address fax:** (772) 245-4235
- **Mailing address:** 266 NW PEACOCK BLVD STE 204, PORT ST LUCIE, FL 34986-2271
- **Mailing address phone:** (772) 262-0852
- **Mailing address fax:** (772) 245-4235

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |

## Other

- **Enumeration date:** 08/26/2022
- **Last updated:** 05/11/2023