Innovative Spine Care, Inc.

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

ME 105674 Issued in FL

Legal business name

INNOVATIVE SPINE CARE, INC.

Practice address

1700 N McMullen Booth Rd
Suite A2-1
Clearwater, FL 33759-2130

Phone

(727) 360-6315

Fax

(408) 228-8953

NPI assigned

Oct 17, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Stephen David Watson, M.D.

Title

Owner

Phone

(727) 360-6315

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1318809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318809600000",
    "number": "1932484367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 BEACH PLZ APT 901",
            "city": "ST PETE BEACH",
            "state": "FL",
            "postal_code": "337063662",
            "telephone_number": "727-360-6315",
            "fax_number": "408-228-8953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 N MCMULLEN BOOTH RD",
            "address_2": "SUITE A2-1",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337592130",
            "telephone_number": "727-360-6315",
            "fax_number": "408-228-8953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE SPINE CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-17",
        "last_updated": "2011-10-17",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-360-6315",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "FL",
            "license": "ME 105674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pain Medicine Physician in Clearwater, FL
• Providers in Clearwater, 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 Oct 17, 2011; 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.