Organization Active NPI

Florida Spine and Sport Inc

  • General Practice Physician
  • Davie, FL
National Provider Identifier
1235567363
Registry record updated Jan 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
FLORIDA SPINE AND SPORT INC
Practice address
2240 SW 70TH Ave Ste D
Davie, FL 33317-7112
Phone
(954) 430-8000
NPI assigned
Oct 29, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2021

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

Authorized official

Name
Mr. Robert M Kustin, DC
Title
Manager
Phone
(954) 430-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

2240 SW 70TH Ave Ste D
Davie, FL 33317-7112

Mailing address

2240 SW 70TH Ave Ste D
Davie, FL 33317-7112
Phone (954) 609-6980

National Provider Directory

National Provider Directory

Locations

2240 SW 70th Ave
Ste D
Davie, FL 33317
Phone (855) 365-6927

17743 SW 2nd St
Pembroke Pines, FL 33029
Phone (954) 430-8000

Practitioners & affiliated clinicians

Practitioners 2

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": "1383004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609891200000",
    "number": "1235567363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2240 SW 70TH AVE STE D",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333177112",
            "telephone_number": "954-609-6980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 SW 70TH AVE STE D",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333177112",
            "telephone_number": "954-430-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA SPINE AND SPORT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-29",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A",
        "authorized_official_last_name": "KUSTIN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "954-430-8000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2021; 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.