PSL Ortho Spine Corp

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

PSL ORTHO SPINE CORP

Practice address

266 NW Peacock Blvd Ste 204
Port St Lucie, FL 34986-2271

Phone

(772) 262-0852

Fax

(772) 245-4235

NPI assigned

Aug 26, 2022

Organization subpart

No

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

Authorized official

Name

Laura C Beatty

Title

Practice Manager

Phone

(772) 262-0852

Specialties & licenses 2

Addresses

Other names 1

• Apex Ortho Spine Doing business as

Locations

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

{
    "created_epoch": "1661472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683763200000",
    "number": "1154040640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "266 NW PEACOCK BLVD STE 204",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349862271",
            "telephone_number": "772-262-0852",
            "fax_number": "772-245-4235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "266 NW PEACOCK BLVD STE 204",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349862271",
            "telephone_number": "772-262-0852",
            "fax_number": "772-245-4235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSL ORTHO SPINE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-26",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A",
        "authorized_official_last_name": "BEATTY",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "772-262-0852"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Apex Ortho Spine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Orthopaedic Surgery Physician in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Orthopaedic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; 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.