Provider Demographics
NPI:1184471104
Name:INTERVENTIONAL SPINE SPECIALISTS OF SOUTH FLORIDA LLC
Entity type:Organization
Organization Name:INTERVENTIONAL SPINE SPECIALISTS OF SOUTH FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HICHAM
Authorized Official - Middle Name:SAMIR
Authorized Official - Last Name:MERHEB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-955-0169
Mailing Address - Street 1:1 NE 167TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-3402
Mailing Address - Country:US
Mailing Address - Phone:305-432-9565
Mailing Address - Fax:305-432-9567
Practice Address - Street 1:1 NE 167TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-3402
Practice Address - Country:US
Practice Address - Phone:305-432-9565
Practice Address - Fax:305-432-9567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty