# FL SPINE & MEDICAL CENTER, PLLC

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

## Provider details

- **NPI number:** 1942746763
- **Authorized official:** DR. MARK KANTZLER D.O. (MGR)
- **Authorized official phone:** (727) 799-2225

## Contact information

- **Practice address:** 1531 S MISSOURI AVE, CLEARWATER, FL 33756-2236
- **Practice address phone:** (727) 799-2225
- **Practice address fax:** (727) 799-2226
- **Mailing address:** 1531 S MISSOURI AVE, CLEARWATER, FL 33756-2236
- **Mailing address phone:** (727) 799-2225
- **Mailing address fax:** (727) 799-2226

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | OS5165 | FL | Yes |

## Other

- **Enumeration date:** 01/18/2017
- **Last updated:** 01/18/2017