Organization
DIVINE ORTHOPEDICS AND SPINE LLC
Active
Other names
DIVINE ORTHOPEDICS AND SPINE LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN KUPPINGER (SOLE MEMBER)
(561) 699-6373
Entity
Organization
Contact information
Practice address
111 E MONUMENT AVE UNIT 515, KISSIMMEE, FL 34741-5779
(561) 908-3200
(561) 790-8553
Mailing address
1006 WHITE DR, DELRAY BEACH, FL 33483-6527
(561) 699-6373
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
Other
Enumeration date
06/15/2021
Last updated
06/15/2021
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