Organization
NEXUS SPINE INSTITUTE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS HEATHER M TRAVIS (CHIEF OPERATING OFFICER)
(813) 358-3578
Entity
Organization
Contact information
Practice address
10676 BLOOMINGDALE AVE STE 3, RIVERVIEW, FL 33578-4292
(813) 358-3578
Mailing address
107 N 11TH ST # 508, TAMPA, FL 33602-4242
(813) 358-3578
Taxonomy
Speciality
Code
Description
License number
State
111NX0800X
Orthopedic Chiropractor
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1811193444
NPI
—
Enumeration date
01/08/2021
Last updated
01/08/2021
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