Provider Demographics
NPI:1427135714
Name:NEUROSPINAL ASSOCIATES PA
Entity type:Organization
Organization Name:NEUROSPINAL ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOOKKEEPER/PERSONNEL SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:REEVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-794-3118
Mailing Address - Street 1:200 3RD AVE W
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34205-8626
Mailing Address - Country:US
Mailing Address - Phone:941-794-3118
Mailing Address - Fax:941-782-2017
Practice Address - Street 1:200 3RD AVE W
Practice Address - Street 2:SUITE 200
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-8626
Practice Address - Country:US
Practice Address - Phone:941-794-3118
Practice Address - Fax:941-782-2017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL264536000Medicaid
FL264534300Medicaid
FL264535100Medicaid
FL264537800Medicaid
FL264537801Medicaid
FL264537800Medicaid