Organization
SPINECARE ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARL R NOBACK MD (PRESIDENT)
(941) 360-1566
Entity
Organization
Contact information
Practice address
1564 KINGSLEY AVE, ORANGE PARK, FL 32073-4511
(904) 264-0400
Mailing address
5700 MIDNIGHT PASS RD, SUITE 4, SARASOTA, FL 34242-3083
(888) 337-3509
(941) 328-3997
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
—
—
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
98887
BCBSFL
FL
Enumeration date
10/13/2008
Last updated
02/07/2011
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