Provider Demographics
NPI:1780408476
Name:MIAMI INTERVENTIONAL SPINE INC
Entity type:Organization
Organization Name:MIAMI INTERVENTIONAL SPINE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-392-0229
Mailing Address - Street 1:7910 NW 25TH ST STE 209
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33122-1622
Mailing Address - Country:US
Mailing Address - Phone:305-392-0229
Mailing Address - Fax:786-329-6519
Practice Address - Street 1:7910 NW 25TH ST STE 209
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33122-1622
Practice Address - Country:US
Practice Address - Phone:305-392-0229
Practice Address - Fax:786-329-6519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-11
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center