# LASER SPINE INSTITUTE LLC SOLE MBR

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Spine DME Solutions LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730691403
- **Authorized official:** DR. MICHAEL PERRY MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (813) 289-9613

## Contact information

- **Practice address:** 656 E SWEDESFORD RD, WAYNE, PA 19087-1606
- **Practice address phone:** (813) 289-9613
- **Practice address fax:** (484) 253-1790
- **Mailing address:** 5332 AVION PARK DR, TAMPA, FL 33607-1412
- **Mailing address phone:** (813) 392-7604
- **Mailing address fax:** (484) 253-1790

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 11/02/2017
- **Last updated:** 11/02/2017