Organization
ALLEGIANCE ORTHOPEDIC NEUROSURGERY AND SPINE INSTITUTE LLC
Active
Organization
ALLEGIANCE ORTHOPEDIC NEUROSURGERY AND SPINE INSTITUTE LLC
Active
Other names
Blackstone Medical Group LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE RICCA (MANAGING PARTNER/OWNER)
(561) 306-5383
Entity
Organization
Contact information
Practice address
190 CONGRESS PARK DR STE 160, DELRAY BEACH, FL 33445-4707
(561) 306-5383
Mailing address
190 CONGRESS PARK DR STE 160, DELRAY BEACH, FL 33445-4707
(561) 306-5383
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
01/18/2019
Last updated
07/08/2019
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