NPIMap

Organization Active NPI

Lake Mary Spine & Rehabilitation Center

  • Clinic/Center
  • Davenport, FL
National Provider Identifier
1003473349
Registry record updated May 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
LAKE MARY SPINE & REHABILITATION CENTER
Practice address
45677 Highway 27
Davenport, FL 33897-4546
Phone
(407) 942-3258
Fax
(440) 794-2331
NPI assigned
May 22, 2019
Organization subpart
Yes
Parent organization
LAKE MARY SPINE & REHABILITATION CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 22, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Yanina Genao, DCNPI 1013251032
Title
Owner/Doctor
Phone
(407) 942-3258

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

45677 Highway 27
Davenport, FL 33897-4546

Mailing address

45677 Highway 27
Davenport, FL 33897-4546
Phone (407) 942-3258

Other names 1

  • Davenport Spine and Rehab Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lee Vista Chiropractic3 organizations share this tax ID, including this one
Part of
Lee Vista Chiropractic

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1558483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558483200000",
    "number": "1003473349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45677 HIGHWAY 27",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338974546",
            "telephone_number": "407-942-3258",
            "fax_number": "407-942-3316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45677 HIGHWAY 27",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338974546",
            "telephone_number": "407-942-3258",
            "fax_number": "440-794-2331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE MARY SPINE & REHABILITATION CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LAKE MARY SPINE & REHABILITATION CENTER",
        "enumeration_date": "2019-05-22",
        "last_updated": "2019-05-22",
        "status": "A",
        "authorized_official_last_name": "GENAO",
        "authorized_official_first_name": "YANINA",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "407-942-3258",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Davenport Spine and Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Davenport, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.