Provider Demographics
NPI:1386009975
Name:PINELLAS SPINE AND JOINT INC
Entity type:Organization
Organization Name:PINELLAS SPINE AND JOINT INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MCPHERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-475-2608
Mailing Address - Street 1:PO BOX 135942
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34713-5942
Mailing Address - Country:US
Mailing Address - Phone:727-475-2608
Mailing Address - Fax:888-788-8345
Practice Address - Street 1:4831 34TH ST S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33711-4509
Practice Address - Country:US
Practice Address - Phone:727-475-2608
Practice Address - Fax:888-788-8345
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-23
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11147111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty