Provider Demographics
NPI:1427689975
Name:INTEGRITY SPINE & ORTHOPEDICS OF MELBOURNE LLC
Entity type:Organization
Organization Name:INTEGRITY SPINE & ORTHOPEDICS OF MELBOURNE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALCANTARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-456-0017
Mailing Address - Street 1:PO BOX 550695
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32255-0695
Mailing Address - Country:US
Mailing Address - Phone:904-456-0017
Mailing Address - Fax:
Practice Address - Street 1:1640 HIGHWAY A1A STE C
Practice Address - Street 2:
Practice Address - City:SATELLITE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-5451
Practice Address - Country:US
Practice Address - Phone:904-456-0017
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-03
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty