Provider Demographics
NPI:1962123224
Name:SPINE SENTRIC
Entity type:Organization
Organization Name:SPINE SENTRIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING/CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:ELEANOR
Authorized Official - Middle Name:
Authorized Official - Last Name:OSTBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-420-2881
Mailing Address - Street 1:2719 HOLLYWOOD BLVD # A-2014
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-4821
Mailing Address - Country:US
Mailing Address - Phone:954-354-2555
Mailing Address - Fax:
Practice Address - Street 1:2719 HOLLYWOOD BLVD # A-2014
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-4821
Practice Address - Country:US
Practice Address - Phone:954-354-2555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty