Spine Pain Clinic of Florida LLC

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

Legal business name

SPINE PAIN CLINIC OF FLORIDA LLC

Practice address

1040 37TH PL Ste 102
Vero Beach, FL 32960-4808

Phone

(561) 229-3744

NPI assigned

Oct 4, 2018

Organization subpart

No

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

Authorized official

Name

Jose Luis Ortega, M. D.

Title

President

Phone

(561) 229-3744

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1538611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575849600000",
    "number": "1851866990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 JUPITER LAKES BLVD STE A",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334587196",
            "telephone_number": "561-229-3744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 37TH PL STE 102",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604808",
            "telephone_number": "561-229-3744"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "140 Jupiter Lakes Blvd Ste A",
            "address_purpose": "LOCATION",
            "city": "Jupiter",
            "state": "FL",
            "postal_code": "33458",
            "country_code": "US",
            "telephone_number": "561-229-3744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPINE PAIN CLINIC OF FLORIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-04",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A",
        "authorized_official_last_name": "ORTEGA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "LUIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-229-3744",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Spillers, OTR
• Laura Ann Spillis, MS
• Spinal Decompression Center LLC
• Spine & Sport Institute, Inc.
• Spine Care America PC
• Sports Medicine & Rehabilitation (Smart PT)
• Monika Srivastava, M.D.
• SSK Ophthalmology LLC
• Patricia Alexandria St Mary Durling, LMT
• Aubrey Anna St Mary

• Pain Medicine Physician in Vero Beach, FL
• Providers in Vero Beach, FL by specialty
• Pain Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2019; 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.