Provider Demographics
NPI:1316261050
Name:HABANA SPINE AND MEDICAL CLINIC
Entity type:Organization
Organization Name:HABANA SPINE AND MEDICAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:813-402-2946
Mailing Address - Street 1:4600 N HABANA AVE STE 32
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-7123
Mailing Address - Country:US
Mailing Address - Phone:813-402-2946
Mailing Address - Fax:813-402-2947
Practice Address - Street 1:4600 N HABANA AVE STE 32
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-7123
Practice Address - Country:US
Practice Address - Phone:813-402-2946
Practice Address - Fax:813-402-2947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-24
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty