Balanced Spine Center, Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH11376 Issued in FL

Legal business name

BALANCED SPINE CENTER, INC.

Practice address

192 W Hwy 50
Clermont, FL 34711-3078

Phone

(352) 708-5333

NPI assigned

Oct 6, 2015

Last updated

Feb 1, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jose Emilio Portela-Berrios, D.C.NPI 1811395841

Title

Doctor of Chiropractic Medicine

Phone

(352) 223-7227

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jose Emilio Portela-Berrios, D.C.

  • Chiropractor
  • Clermont, FL
  • NPI 1811395841
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1444089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454284800000",
    "number": "1336519099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11010 POINT NELLIE DR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347118663",
            "telephone_number": "352-223-7227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "192 W HWY 50",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347113078",
            "telephone_number": "352-708-5333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCED SPINE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-06",
        "last_updated": "2016-02-01",
        "status": "A",
        "authorized_official_last_name": "PORTELA-BERRIOS",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "EMILIO",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC MEDICINE",
        "authorized_official_telephone_number": "352-223-7227",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH11376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Ann Baker, PHARMD
• Quincetta Baker
• Tiffany Noelle Baker
• Tomette M Baker, COTA/L
• Nailah Baksh, PHARMD
• Shelby Marie Ball
• Angela M. Balon, D.O.
• Paola Amada Balseca, RMHCI
• Rodrigo Baltodano, MD
• Bandur Chiropractic Center

• Chiropractor in Clermont, FL
• Providers in Clermont, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2016; 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.