Organization
BRAIN AND SPINE INSTITUTE FOR CHILDREN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEYNE K JOHNSON M. D. (PRESIDENT/OWNER)
(407) 378-5100
Entity
Organization
Contact information
Practice address
25 W KALEY ST, SUITE 200, ORLANDO, FL 32806-2939
(407) 255-2152
(407) 264-8395
Mailing address
25 W KALEY ST, SUITE 200, ORLANDO, FL 32806-2939
(407) 255-2152
(407) 264-8395
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
Other
Enumeration date
03/12/2013
Last updated
06/09/2013
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