Organization
SPINE CENTER OF SOUTH FLORIDA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENEANE MARIE WAKULA (ADMINISTRATION)
(772) 546-9591
Entity
Organization
Contact information
Practice address
815 SE 1ST AVE, HALLANDALE BEACH, FL 33009-7102
(772) 546-9591
Mailing address
815 SE 1ST AVE, HALLANDALE BEACH, FL 33009-7102
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME98523
FL
Other
Enumeration date
02/11/2010
Last updated
02/11/2010
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