Provider Demographics
NPI:1902327133
Name:BRAIN AND SPINE NEUROSCIENCE INSTITUTE, LLC
Entity Type:Organization
Organization Name:BRAIN AND SPINE NEUROSCIENCE INSTITUTE, LLC
Other - Org Name:MINIMALLY INVASIVE SURGICAL SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:630-918-9296
Mailing Address - Street 1:16506 POINTE VILLAGE DR STE 107
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558-5255
Mailing Address - Country:US
Mailing Address - Phone:630-918-9296
Mailing Address - Fax:813-336-4466
Practice Address - Street 1:7657 CITA LN
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-6221
Practice Address - Country:US
Practice Address - Phone:813-563-2310
Practice Address - Fax:727-312-4841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-28
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty