Brain and Spine Institute of Port Orange, LLC
NPI #1699016949 in Port Orange, Florida
Provider Information
- NPI Number
- 1699016949
- Entity Type
- Organization
- Organization Name
- Brain and Spine Institute of Port Orange, LLC
- Primary Specialty
- Psychiatry & Neurology - Neurology
- Enumeration Date
- Mar 12, 2013
- Last Updated
- Mar 15, 2013
Practice Location
- Address
- 1211 DUNLAWTON AVE
- City
- Port Orange
- State
- Florida
- ZIP Code
- 32127-2913
- Phone
- (386) 304-0111
Authorized Official
- Name
- DR. TIMOTHY JOSEPH WIERZBICKI, M.D.
- Title
- CEO
- Phone
- (386) 304-0111
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychiatry & Neurology - Neurology — Neurology |
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