Minimally Invasive Spine Center of South Florida, LLC

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

Legal business name

MINIMALLY INVASIVE SPINE CENTER OF SOUTH FLORIDA, LLC

Practice address

475 Biltmore Way Ste 101
Coral Gables, FL 33134-5724

Phone

(305) 393-8810

Fax

(305) 393-8811

NPI assigned

Aug 11, 2017

Organization subpart

No

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

Authorized official

Name

Nicole Graveran

Title

Manager

Phone

(305) 677-9723

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jorge A Lerma Lopez, ARNP

  • Nurse Practitioner
  • Coral Gables, FL
  • NPI 1225629280
  Medicare reassignment Care Compare group NPD
• Karina Lynn Gass, DPT, PA-C

  • Physician Assistant
  • Coral Gables, FL
  • NPI 1063941367
  Medicare reassignment Care Compare group
• Amir Mahajer, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Miami, FL
  • NPI 1770829541
  Medicare reassignment Care Compare group
• Kevin Paul O'Donnell, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Moorestown, NJ
  • NPI 1881918704

  FL

  Medicare reassignment

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

{
    "created_epoch": "1502409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736812800000",
    "number": "1972028884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 BILTMORE WAY STE 101",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331345724",
            "telephone_number": "305-393-8810",
            "fax_number": "305-393-8811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 BILTMORE WAY STE 101",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331345724",
            "telephone_number": "305-393-8810",
            "fax_number": "305-393-8811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3659 S Miami Ave Ste 4002",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331334231",
            "country_code": "US",
            "telephone_number": "305-393-8810",
            "fax_number": "305-393-8811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MINIMALLY INVASIVE SPINE CENTER OF SOUTH FLORIDA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-11",
        "last_updated": "2025-01-14",
        "certification_date": "2024-12-16",
        "status": "A",
        "authorized_official_last_name": "GRAVERAN",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "305-677-9723"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthopaedic Surgery of the Spine Physician in Coral Gables, FL
• Providers in Coral Gables, FL by specialty
• Orthopaedic Surgery of the Spine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; 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.