Provider Demographics
NPI:1104268739
Name:SEMINOLE NEUROSURGERY & SPINE CENTER LLC
Entity type:Organization
Organization Name:SEMINOLE NEUROSURGERY & SPINE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROSURGEON
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:J
Authorized Official - Last Name:CUFFE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-397-1897
Mailing Address - Street 1:280 S STATE ROAD 434 STE 1049A
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-3859
Mailing Address - Country:US
Mailing Address - Phone:321-397-1897
Mailing Address - Fax:
Practice Address - Street 1:280 S STATE ROAD 434 STE 1049A
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-3859
Practice Address - Country:US
Practice Address - Phone:321-397-1897
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-24
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME64345174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty