Provider Demographics
NPI:1194693218
Name:SPINE AND JOINT CENTERS FL CLINIC, LLC
Entity type:Organization
Organization Name:SPINE AND JOINT CENTERS FL CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CAMILLE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-505-9115
Mailing Address - Street 1:6716 NW 11TH PL STE 101
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4201
Mailing Address - Country:US
Mailing Address - Phone:352-505-9115
Mailing Address - Fax:352-240-3490
Practice Address - Street 1:6716 NW 11TH PL STE 101
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4201
Practice Address - Country:US
Practice Address - Phone:352-505-9115
Practice Address - Fax:352-240-3490
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPINE AND JOINT CENTERS OF AMERICA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-10-29
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center