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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