Active NPI
Interventional Spine Institute of Florida, PA
- Specialist
- Rockledge, FL
National Provider Identifier
1154739258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 60952
- Legal business name
- INTERVENTIONAL SPINE INSTITUTE OF FLORIDA, PA
- Practice address
- 389 Commerce Pkwy
Suite 120
Rockledge, FL 32955-4202 - Phone
- (321) 733-0064
- Fax
- (321) 733-7970
- NPI assigned
- Aug 1, 2014
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Brian C Dowdell, M.D.
- Title
- Owner/Ceo/President
- Phone
- (321) 733-0064
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 60952 | FL | Primary |
| Durable Medical Equipment & Medical Supplies | 332B00000X | 60952 | FL |
Addresses
Primary practice location
389 Commerce Pkwy
Suite 120
Rockledge, FL 32955-4202
Mailing address
308 S Harbor City Blvd
Suite a
Melbourne, FL 32901-1500
Phone (321) 733-0064
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225060338 | Other | FL | NPI GROUP |
| 1326453143 | Other | FL | NPI-DME-MELBOURNE |
| 1639101744 | Other | FL | NPI INDIVIDUAL |
| 10708014 | Other | FL | CAQH |
| K5708 | Other | FL | MEDICARE GROUP |
| ME76009 | Other | FL | MEDICAL LICENSE |
Other names 1
- Spine, Orthopedics and Rehabilitation
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406851200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1678147200000",
"number": "1154739258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "308 S HARBOR CITY BLVD",
"address_2": "SUITE A",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329011500",
"telephone_number": "321-733-0064",
"fax_number": "321-733-7970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "389 COMMERCE PKWY",
"address_2": "SUITE 120",
"city": "ROCKLEDGE",
"state": "FL",
"postal_code": "329554202",
"telephone_number": "321-733-0064",
"fax_number": "321-733-7970"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INTERVENTIONAL SPINE INSTITUTE OF FLORIDA, PA",
"organizational_subpart": "NO",
"enumeration_date": "2014-08-01",
"last_updated": "2023-03-07",
"status": "A",
"authorized_official_last_name": "DOWDELL",
"authorized_official_first_name": "BRIAN",
"authorized_official_middle_name": "C",
"authorized_official_title_or_position": "OWNER/CEO/PRESIDENT",
"authorized_official_telephone_number": "321-733-0064",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": "FL",
"license": "60952",
"primary": true
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "FL",
"license": "60952",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI GROUP",
"identifier": "1225060338",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI-DME-MELBOURNE",
"identifier": "1326453143",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI INDIVIDUAL",
"identifier": "1639101744",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "10708014",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP",
"identifier": "K5708",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "ME76009",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Spine, Orthopedics and Rehabilitation",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Rockledge, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.