Organization
SOUTH BAY NEUROLOGY AND TOTAL SPINE CARE, P.A.
Active
Other names
SOUTH BAY PRIMARY NEUROLOGY CARE, P.A.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER LINTAO VALENCIA M.D. (PRESIDENT)
(813) 634-3323
Entity
Organization
Contact information
Practice address
4051 UPPER CREEK DR, SUITE 111, SUN CITY CENTER, FL 33573-6825
(813) 634-3323
(813) 634-4764
Mailing address
4051 UPPER CREEK DR, SUITE 111, SUN CITY CENTER, FL 33573-6825
(813) 634-3323
(813) 634-4764
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
94898
BLUE CROSS BLUE SHIELD FL
FL
01
—
CH9703
RAILROAD MEDICARE
FL
Enumeration date
02/22/2007
Last updated
08/22/2020
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