Divine Orthopedics and Spine LLC

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

Legal business name

DIVINE ORTHOPEDICS AND SPINE LLC

Practice address

111 E Monument Ave Unit 515
Kissimmee, FL 34741-5779

Phone

(561) 908-3200

Fax

(561) 790-8553

NPI assigned

Jun 15, 2021

Organization subpart

No

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

Authorized official

Name

Jordan Kuppinger

Title

Sole Member

Phone

(561) 699-6373

Specialties & licenses 1

Addresses

Other names 1

• DIVINE ORTHOPEDICS AND SPINE LLC Doing business as

Locations

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

{
    "created_epoch": "1623715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623715200000",
    "number": "1609444728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 WHITE DR",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334836527",
            "telephone_number": "561-699-6373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E MONUMENT AVE UNIT 515",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347415779",
            "telephone_number": "561-908-3200",
            "fax_number": "561-790-8553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE ORTHOPEDICS AND SPINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-15",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A",
        "authorized_official_last_name": "KUPPINGER",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "561-699-6373"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DIVINE ORTHOPEDICS AND SPINE LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christian Disla, AP
• Carolyn Divers, LCSW
• Divine Healthcare Agency LLC
• Divine Home Health Care II, Inc
• Divine Manor Assisted Living Facility Inc
• Divine Solutions Residential Services LLC.
• Pamela Dixon Brewer, CNA, PHLEBOTOMIST
• Drake Dixon
• Ruby Johne Dixon, LMHC
• DJMP Management Florida LLC

• Neurological Surgery Physician in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Neurological Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.