Provider Demographics
NPI:1104543107
Name:CARIBBEAN SPINE AND SPORTS INSTITUTE PLLC
Entity type:Organization
Organization Name:CARIBBEAN SPINE AND SPORTS INSTITUTE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:STEVE
Authorized Official - Last Name:FONSECA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-866-2800
Mailing Address - Street 1:6331 GREENLEAF AVE STE J
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90601-3553
Mailing Address - Country:US
Mailing Address - Phone:714-866-2800
Mailing Address - Fax:
Practice Address - Street 1:9149 ESTATE THOMAS STE 202
Practice Address - Street 2:
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-3132
Practice Address - Country:US
Practice Address - Phone:340-489-0424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-21
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty