NPIMap

Organization Active NPI

Vital Orthopedic & Spine Institute, Inc

  • Specialist
  • Coconut Creek, FL
National Provider Identifier
1104285725
Registry record updated Feb 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME114632 Issued in FL
Legal business name
VITAL ORTHOPEDIC & SPINE INSTITUTE, INC
Practice address
4848 Coconut Creek Pkwy # 200
Coconut Creek, FL 33063-3904
Phone
(877) 848-2507
NPI assigned
Feb 11, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2016

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

Authorized official

Name
Dr. Robere J Missirian, MDNPI 1326255134
Title
Owner
Phone
(877) 848-2507

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X ME114632 FL Primary

Addresses

Primary practice location

4848 Coconut Creek Pkwy # 200
Coconut Creek, FL 33063-3904

Mailing address

1730 S Federal Hwy # 199
Delray Beach, FL 33483-3309

National Provider Directory

National Provider Directory

Locations

1730 S Federal Hwy
#199
Delray Beach, FL 33483

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": "1455148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455840000000",
    "number": "1104285725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 S FEDERAL HWY # 199",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334833309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4848 COCONUT CREEK PKWY # 200",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330633904",
            "telephone_number": "877-848-2507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL ORTHOPEDIC & SPINE INSTITUTE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-11",
        "last_updated": "2016-02-19",
        "status": "A",
        "authorized_official_last_name": "MISSIRIAN",
        "authorized_official_first_name": "ROBERE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "877-848-2507",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME114632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coconut Creek, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2016; 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.