Organization
SPINE THERAPY INC
Active
Parent organization
GULFCOAST SPINE INSTITUTE, PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
GULFCOAST SPINE INSTITUTE, PA
Authorized official
MR. JAMES JOSEPH RONZO D.O. (OWNER)
(352) 697-2341
Entity
Organization
Contact information
Practice address
4211 W BOY SCOUT BLVD STE 400, TAMPA, FL 33607-5766
(813) 443-2108
(813) 443-8255
Mailing address
2300 E. NORVELL BRYAUT HWY, SPINE THERAPY INC, HERNANDO, FL 34442-8902
(352) 341-4778
(352) 341-4477
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
2251X0800X
Orthopedic Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DF4724
RAIL ROAD MEDICARE
FL
01
—
Y927L
BLUE SHIELD
FL
Enumeration date
06/15/2010
Last updated
10/11/2018
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