# FLORIDA SPINE AND PAIN, LLC

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

## Provider details

- **NPI number:** 1801346184
- **Authorized official:** VIJAY GUTTI BABU M.D. (CEO)
- **Authorized official phone:** (352) 775-2826

## Contact information

- **Practice address:** 1400 N US HWY 441, STE 536, LADY LAKE, FL 32159-8986
- **Practice address phone:** (352) 775-2826
- **Practice address fax:** (352) 547-4011
- **Mailing address:** 1400 N US HWY 441, STE 536, LADY LAKE, FL 32159-8986
- **Mailing address phone:** (352) 775-2826
- **Mailing address fax:** (352) 547-4011

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | ME126127 | FL | Yes |

## Other

- **Enumeration date:** 10/10/2016
- **Last updated:** 03/04/2017