# PRIME ORTHO & SPINE LLC

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

## Provider details

- **NPI number:** 1306756275
- **Authorized official:** SHATINA CANNON (ADMINISTRATOR)
- **Authorized official phone:** (954) 751-4490

## Contact information

- **Practice address:** 342 HAMBURG TPKE STE 209, WAYNE, NJ 07470-2166
- **Practice address phone:** (954) 751-4490
- **Mailing address:** 2001 W SAMPLE RD STE 318, DEERFIELD BEACH, FL 33064-1342
- **Mailing address phone:** (954) 751-4490

## Taxonomy

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

## Other

- **Enumeration date:** 09/11/2026
- **Last updated:** 09/11/2026