Organization
JACKSONVILLE SPINE CENTER PA
Active
Organization
JACKSONVILLE SPINE CENTER PA
Active
Other names
Centurion Spine & Pain Centers
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA M GROTH (CREDENTIALING MANAGER)
(904) 223-3321
Entity
Organization
Contact information
Practice address
659 DOUGLAS AVE, ALTAMONTE SPRINGS, FL 32714-2509
(904) 223-3321
Mailing address
5191 FIRST COAST TECH PKWY FL 3, JACKSONVILLE, FL 32224-0609
(904) 223-3321
(904) 223-2169
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
04/05/2023
Last updated
04/05/2023
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