NPIMap

Organization Active NPI

Gulfcoast Spine Institute, LLC

  • Orthopaedic Surgery of the Spine Physician
  • Orange City, FL
National Provider Identifier
1619635265
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
Practice address
1105 Saxon Blvd Ste 202
Orange City, FL 32763-8470
Phone
(386) 261-9491
Fax
(813) 443-8255
NPI assigned
Dec 1, 2021
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 Ronzo, DO
Title
President
Phone
(386) 261-9491

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

1105 Saxon Blvd Ste 202
Orange City, FL 32763-8470

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

National Provider Directory

National Provider Directory
Tax ID family
Spine Therapy Inc6 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

1105 Saxon Blvd
Ste 202
Orange City, FL 32763
Phone (386) 261-9491

NPI Registry JSON

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

{
    "created_epoch": "1638316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699315200000",
    "number": "1619635265",
    "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": "813-443-8255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 SAXON BLVD STE 202",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638470",
            "telephone_number": "386-261-9491",
            "fax_number": "813-443-8255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULFCOAST SPINE INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-01",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A",
        "authorized_official_last_name": "RONZO",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-261-9491",
        "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"
        },
        {
            "organization_name": "BioSpine Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orange City, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.