Organization
CHARLES S. THEOFILOS MD PA
Active
Other names
The Spine Center
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES S THEOFILOS (PHYSICIAN OWNER)
(561) 630-3870
Entity
Organization
Contact information
Practice address
300 VILLAGE SQUARE XING STE 202, PALM BEACH GARDENS, FL 33410-3223
(561) 630-3870
(561) 630-3680
Mailing address
300 VILLAGE SQUARE XING STE 202, PALM BEACH GARDENS, FL 33410-3223
(561) 630-3870
(561) 630-3680
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
XXXXXXXXXXXXXXXX
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23144
INDIVIDUAL MEDICARE NUMBE
FL
05
—
373280100
—
FL
Enumeration date
05/17/2006
Last updated
04/28/2021
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