# SPINE INSTITUTE ON THE EMERALD COAST

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Coastal Neurosurgery & Spine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184235558
- **Authorized official:** AMRISH PATEL MD (CHIEF MEDICAL OFFICER, OWNER)
- **Authorized official phone:** (706) 580-3607

## Contact information

- **Practice address:** 350G RACETRACK RD NW, FORT WALTON BEACH, FL 32547-1699
- **Practice address phone:** (850) 460-2350
- **Mailing address:** PO BOX 600366, ST JOHNS, FL 32260-0366
- **Mailing address phone:** (904) 717-9625
- **Mailing address fax:** (904) 683-6499

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 08/11/2020
- **Last updated:** 04/10/2024