NPIMap

Organization Active NPI

Gulfcoast Spine Institute, LLC

Doing business as BioSpine Institute

  • Orthopaedic Surgery of the Spine Physician
  • Orlando, FL
National Provider Identifier
1174040828
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
Legal business name
GULFCOAST SPINE INSTITUTE, LLC
Doing business as
BioSpine Institute
Practice address
3902 Millenia Blvd Ste 300
Orlando, FL 32839-6407
Phone
(813) 443-2108
Fax
(813) 284-7952
NPI assigned
Aug 24, 2017
Last updated
Nov 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Authorized official

Name
James J Ronzo, DO
Title
Owner
Phone
(813) 443-2108

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207T00000X
Orthopaedic Surgery of the Spine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207XS0117X Primary

Addresses

Primary practice location

3902 Millenia Blvd Ste 300
Orlando, FL 32839-6407

Mailing address

4211 W Boy Scout Blvd Ste 400
Tampa, FL 33607-5766
Phone (813) 443-2108

Other names 1

  • BioSpine Institute Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200219000391 FL DME Supplier - Physician - Osteopathic Manipulative MedicineDME Supplier - Physician - Orthopedic/Orthopedic Surgery 0749226215 Practice locations: Orlando, FL

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Gulfcoast Spine Institute P6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

3900 Millenia Blvd
Ste 300
Orlando, FL 32839

NPI Registry JSON

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

{
    "created_epoch": "1503532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699315200000",
    "number": "1174040828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4211 W BOY SCOUT BLVD STE 400",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336075766",
            "telephone_number": "813-443-2108",
            "fax_number": "813-284-7952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3902 MILLENIA BLVD STE 300",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328396407",
            "telephone_number": "813-443-2108",
            "fax_number": "813-284-7952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULFCOAST SPINE INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-24",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A",
        "authorized_official_last_name": "RONZO",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-443-2108",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BioSpine Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.