Provider Demographics
NPI: | 1174164529 |
---|---|
Name: | SPECIALTY SPINE AND PAIN, PC |
Entity type: | Organization |
Organization Name: | SPECIALTY SPINE AND PAIN, PC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | RCM SR. DIRECTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | NICOLE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | FINKLE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 719-243-9490 |
Mailing Address - Street 1: | 4960 SW 72ND AVE STE 405 |
Mailing Address - Street 2: | |
Mailing Address - City: | MIAMI |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33155-5506 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 469-458-9222 |
Mailing Address - Fax: | 540-918-7202 |
Practice Address - Street 1: | 1240 JESSE JEWELL PKWY SE STE 300 |
Practice Address - Street 2: | |
Practice Address - City: | GAINESVILLE |
Practice Address - State: | GA |
Practice Address - Zip Code: | 30501-3861 |
Practice Address - Country: | US |
Practice Address - Phone: | 770-534-7200 |
Practice Address - Fax: | 770-536-0617 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2019-10-07 |
Last Update Date: | 2025-09-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 208VP0014X | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine | Group - Single Specialty |