Organization
SPACE COAST SPINE AND PAIN INSTITUTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SONYA WARNICK (ADMINISTRATOR)
(321) 432-5480
Entity
Organization
Contact information
Practice address
205 E NASA BLVD STE 200, MELBOURNE, FL 32901-1954
(321) 361-5619
Mailing address
285 LANSING ISLAND DR, INDIAN HARBOUR BEACH, FL 32937-5102
(321) 361-5619
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
Other
Enumeration date
07/24/2021
Last updated
07/24/2021
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