# SOUTHWEST FLORIDA SPINE INSTITUTE PLLC

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

## Provider details

- **NPI number:** 1700045069
- **Authorized official:** DR. MARIO L PEREIRA MD (PHYSICIAN)
- **Authorized official phone:** (941) 979-7310

## Contact information

- **Practice address:** 3420 TAMIAMI TRL, SUITE 1, PORT CHARLOTTE, FL 33952-8126
- **Practice address phone:** (941) 979-7310
- **Mailing address:** PO BOX 494409, PORT CHARLOTTE, FL 33949-4409
- **Mailing address phone:** (941) 979-7310

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | ME98377 | FL | Yes |

## Other

- **Enumeration date:** 06/03/2008
- **Last updated:** 06/03/2008